CPT and ICD9-CM Algorithm
Appendices
Appendix 1: ICD9 CM Spine Surgery Procedure Codes
03.01 Removal of foreign body from spinal canal
03.02 Reopening of laminectomy site
03.09 Other exploration and decompression of spinal canal
81.00 Spinal fusion, not otherwise specified
81.01 Atlas-axis spinal fusion
81.02 Other cervical fusion, anterior technique
03.1 Division of intraspinal nerve root
03.29 Other chordotomy
81.03 Other cervical fusion, posterior technique
81.04 Dorsal and dorsolumbar fusion, anterior technique
03.4 Excision of destruction of lesion of spinal cord or spinal meninges
03.51 Repair spinal meningocele
03.53 Repair of vertebral fracture
81.05 Dorsal and dorsolumbar fusion, posterior technique
81.06 Lumbar and lumbosacral fusion, anterior technique
81.07 Lumbar and lumbosacral fusion, lateral transverse process
technique
81.08 Lumbar and lumbosacral fusion, posterior technique
81.30 Refusion of spine, not otherwise specified
03.59 Other repair and plastic operations on spinal cord structures
03.6 Lysis of adhesions of spinal cord and nerve roots
03.71 Spinal subarachnoid-peritoneal shunt
03.79 Other shunt of spinal theca
03.90 Insertion of catheter into spinal canal for infusion of therapeutic or
palliative substances
81.31 Refusion of atlas-axis spine
81.32 Refusion of other cervical spine, anterior technique
81.33 Refusion of other cervical spine, posterior technique
03.92 Injection of other agent into spinal canal
03.93 Implantation or replacement of spinal neurostimulator lead
03.94 Removal of spinal neurostimulator lead(s)
81.34 Refusion of dorsal and dorsolumbar spine, anterior technique
81.35 Refusion of dorsal and dorsolumbar spine, posterior technique
81.36 Refusion of lumbar and lumbosacral spine, anterior technique
03.97 Revision of spinal thecal shunt
03.98 Removal of spinal thecal shunt
81.37 Refusion of lumbar and lumbosacral spine, lateral transverse
process technique
81.38 Refusion of lumbar and lumbosacral spine, posterior technique
03.99 Other operations on spinal cord and spinal canal structures, other
77.69 Local excision of lesion or tissue of bone, other
77.79 Excision of bone for graft, other
81.39 Refusion of spine, NEC
81.62 Fusion or refusion of 2-3 vertebrae
81.63 Fusion or refusion of 4-8 vertebrae
78.49 Other repair or plastic operations on bone, other; other operation
on bone NEC, repair of malunion or nonunion fracture NEC
81.64 Fusion or refusion of 9 or more vertebrae
78.59 Internal fixation of bone without fracture reduction; internal fixation
of bone (prophylactic), reinsertion of internal fixation device, revision of
displaced or broken fixation device, other
81.65 Vertebroplasty
81.66 Kyphoplasty
78.69 Removal of implanted devices from bone; external fixator device
(invasive), internal fixation device, removal of bone growth stimulator
(invasive), removal of internal limb lengthening device, other
84.51 Insertion of interbody spinal fusion device
80.50 Excision or destruction of intervertebral disc, unspecified
80.51 Excision of intervertebral disc
84.52 Insertion of recombinant bone morphogenetic protein
CPT and ICD9-CM Algorithm
Appendix 2: Cervical Spine-Specific ICD9-CM Procedure and Diagnosis Codes
ICD-9
Procedure Code
Anterior Fusion
Description: Cervical-specific
81.02
Other cervical fusion, anterior technique
81.32
Refusion of other cervical spine, anterior technique (arthrodesis of C2 level or below)
Posterior Fusion
81.03
Other cervical fusion, posterior technique
81.33
Refusion of other cervical spine, posterior technique (arthrodesis of C2 level or below)
ICD-9
Diagnosis Code
Herniated Disc
722.0
Spondylosis
721.0
722.4
Myelopathy
721.1
722.71
Radiculopathy
723.4
Spinal Stenosis
723.0
Other
722.81
723.1
723.7
738.2
Description: Cervical-specific
Displacement of cervical disc without myelopathy
Cervical spondylosis without myelopathy
Degeneration of cervical intervertebral disc
Cervical spondylosis with myelopathy
Intervertebral disc disorder with myelopathy, cervical
Brachial neuritis or radiculitis NOS, cervical radiculitis or radicular syndrome of the upper limbs
Spinal stenosis in cervical region
Postlaminectomy syndrome, cervical
Cervicalgia
Ossification of the posterior longitudinal ligament in cervical region
Acquired deformity of neck
Appendix 3: Definite Cervical Spine CPT Codes, Degenerative
22554, +22585
22600, +22614
63001
63015
63020, +63035
63040, +63043
63045, +63048
63050
63051
63075, +63076
63081, +63082
Arthrodesis, anterior, including minimal discectomy to prepare interspace, cervical below C2
Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment; add-on level code
Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy, or
discectomy, (eg, spinal stenosis), 1-2 vertebral segments, cervical
Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy, or
discectomy, (eg, spinal stenosis), more than 2 vertebral segments, cervical
Laminotomy (hemilaminectomy) with decompression of nerve root(s) including partial facetectomy, foraminotomy, and/or excision
of herniated intervertebral disk; one interspace, cervical; -50 for bilateral, add-on for 63020, each additional interspace, cervical or
lumbar
Reexploration laminotomy (hemilaminectomy) with decompression of nerve root(s) including partial facetectomy, foraminotomy,
and/or excision of herniated intervertebral disk, reexploration, single interspace, cervical; -50 for bilateral, add-on for 63020, each
additional interspace, cervical
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or
nerve root(s), (eg, spinal or lateral recess stenosis), single vertebral segment, cervical; add-on is NS
Laminoplasty, cervical, with decompression of the spinal cord, 2+ segments 2005 code
Laminoplasty, cervical, with reconstruction of the posterior bony elements (bridging bone graft, wire, suture, miniplates, etc.)
Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single
interspace; add-on for additional cervical discectomy decompression
Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or
nerve root(s); cervical, single segment; add-on for cervical, each additional segment
CPT and ICD9-CM Algorithm
Appendix 4: Spine Specific (not cervical specific) CPT spine codes
22830
22840
22841
22842,
22843,
22844
22845,
22846,
22847
22849
22850
22851
22852
22855
22899
Exploration of spinal fusion
Posterior nonsegmental instrumentation, pedicle fixation across one interspace, Harrington rods, sublaminar wiring at
C1, atlantoaxial transarticular screw, facet screw fixation
Internal spinal fixation by wiring of spinous process
Posterior segmental instrumentation 3-6 segments, 7-12 segments, 13+ segments
Anterior instrumentation, 2-3, 4-7, 8+ vertebral segments
Reinsertion of spinal fixation device
Removal of posterior nonsegmental instrumentation (eg, Harrington rod)
Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowel(s), methylmethacrylate)
to vertebral defect or interspace (List separately in addition to code for primary procedure)
Removal of posterior segmental instrumentation
Removal of anterior instrumentation
Unlisted procedure, spine (NS)