APPENDIX Table 1: Description of surgical categories and patient
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APPENDIX Table 1: Description of surgical categories and patient selection. Include: Any patient, from the Pediatric ACS NSQIP who underwent a spinal fusion procedure with one of the following CPT codes: 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels AND who DO have an ICD-9 code for a deformity diagnosis in one of the following categories. Category Idiopathic Scoliosis Early Onset Scoliosis Coding 737.30, 737.39, 737.3, 737.19 737.31, 737.32 Congenital Scoliosis Neuromuscular or Syndromic Scoliosis Other Spinal Deformity 343.2, 754.2, 756.13, 756.14, 756.15, 756.16, 756.19,213.2 A NSQIP designation code as neuromuscular scoliosis, 759.82, 737.40, 737.41, 737.42, 737.43, 343.9, 335.10, 335.0, 237.70, 237.71, 237.79, 330.8 737.10, 737.0, 737.10, 737.11, 737.12, 737.19 (Kyphotic Conditions), 737.20, 737.21, 737.22, 737.29 (Lordotic Conditions) Exclude: Patients with a wound class of 2 or 3, patients with an open wound on their body, patients with current sepsis, patients requiring blood pressure support pre-operatively, patients with current pneumonias, patient with prior surgeries within 30 days, patients in a coma at the time of surgery, or any patients undergoing a non-elective procedure. After defining the groups, separate into the following categories according to the type of procedure performed: 1. Isolated Primary Posterior Arthrodesis: Patients who have at least one of the following CPT Codes in any coding position: 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels AND who do NOT have on of the following codes for revision procedures or Anterior Arthrodesis: 22852-removal of posterior segmental instrumentation 22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod) 22855 - removal of anterior instrumentation 22849 - Reinsertion of spinal fixation device 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels 2. Revision Posterior Arthrodesis: Patients who have at least one of the following CPT Codes in any coding position: 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels AND who DO have one of the following three codes for revision: 22852-removal of posterior segmental instrumentation 22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod) 22855 - removal of anterior instrumentation 3. Isolated Primary Anterior Arthrodesis Patients who have at least one of the following CPT Codes in any coding position: 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels AND who DO NOT have one of the following codes for revision procedures or for posterior arthrodesis: 22852-removal of posterior segmental instrumentation 22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod) 22855 - removal of anterior instrumentation 22849 - Reinsertion of spinal fixation device 22800 or 22842 - Poster Fusion and Instrumentation Up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels 4. Revision Anterior Arthrodesis Patients who have at least one of the following CPT Codes in any coding position: 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels AND who DO have one of the following codes for revision procedures: 22852-removal of posterior segmental instrumentation 22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod) 22855 - removal of anterior instrumentation 4. Combined Anterior and Posterior Arthrodesis Patients who have at least one of the following CPT Codes in any coding position: 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels AND who DO have at least one of the following Anterior Fusion Codes: 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels 5. Patients With Bone Grafting: Patients who have at least one of the following CPT Codes in any coding position: 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels AND Who DO have at least one of the following CPT Codes: Autograft (20936, 20937, 20938) Allograft (20930, 20931) Bone Marrow Aspirate (38220) 6. Patients With Fusions to the Pelvis: Patients who have at least one of the following CPT Codes in any coding position: 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels AND Who DO have at least one of the following CPT Codes: 22848 – pelvic fixation 7. Patients who underwent an osteotomy: Patients who have at least one of the following CPT Codes in any coding position: 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels AND Who DO have at least one of the following CPT Codes for osteotomies: 22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226 8. Patients Who Had an Intervertebral Device Inserted Patients who have at least one of the following CPT Codes in any coding position: 22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels 22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels 22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels 22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels 22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels 22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels AND Who DO have at least one of the following CPT Codes for intervertebral device insertion: 22851 Appendix Table 2: Listing of Each Variable and the Number of Cases With Available Data Characteristic Cases Used Age 1890 Gender 1890 Race 1890 BMI 1768 Diabetes 1890 Ventilator Dependent 1890 Asthma 1890 Cystic Fibrosis 1890 Chronic Lung Disease 1890 Oxygen Support 1890 Tracheostomy 1890 Airway Abnormalities 1890 GI Disease 1890 Hepatobiliary Disease 1890 Cardiac Risk Factors 1890 Previous Cardiac Surgery 1890 Acute Renal Failure 1890 Dialysis 1890 History of Stroke 1890 Tumor involving CNS 1890 Developmental Delay 1890 Seizure Disorder 1890 Cerebral Palsy 1890 CNS Abnormality 1890 Neuromuscular Disorder 1890 Immune Disorder 1890 Steroid use w/in 30 Days 1890 Bone Marrow Transplant 1890 Solid Organ Transplant 1890 Recent Weight Loss 1890 Nutritional Support 1890 Bleeding Disorder 1890 Hematologic Disorder 1890 Chemo w/in 30 Days 1890 Rad Therapy w/in 90 Days 1890 Prior Operation w/in 30 Days 1890 Congenital Malformation 1890 Hx Childhood Malignancy 1890 Requires Ionotropic Support 1890 Sodium 997 BUN 943 WBC 1554 Hematocrit 1569 INR 960 Creatinine 944 Albumin 544 ASA Class 1888 Received Blood Transfusion 1890 Blood Transfused 1236 Operative time 1890 Total Case RVUs 1890 LOS 1885 Diagnosis Groups 1890 * ASA = American Society of Anesthesiologists, BMI = Body Mass Index, BUN = Blood Urea Nitrogen, Chemo = Chemotherapy, COPD = Chronic Obstructive Pulmonary Disorder, Hx = History, INR = International Normalized Ratio, LOS = Length of Stay, RVU = Relative Value Units, WBC = White Blood Cell Count, Wt = Weight, W/in = Within.
