Wiki Adult Scoliosis coding

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butterflyed

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2 of my surgeons are stating that the codes 22800-22812 are to be used only in pediatric cases. Does anyone have any information on this?
Thanks
Stacey
 
butterflyed said:
2 of my surgeons are stating that the codes 22800-22812 are to be used only in pediatric cases. Does anyone have any information on this?
Thanks
Stacey
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That's an interesting question. NASS has not mentioned how and when to use deformity codes vs. injury codes (fracture, herniated disc) for fusion. I do know that ICD-10 has an age for these codes (diagnosis).
 
Adult Scoliosis Coding

Hi Stacey - I am reading the Orthopaedic Coding Companion and for these codes there is no mention of age requirements (or limits). In fact, it states under 22800-22804 "The spinal deformity may be congenital (e.g. scoliosis) or acquired due to a disease or other process (e.g. kyphosis). These codes should not be used to report fusion for spinal deformity due to a fracture or previous arthrodesis."

Did the Docs give any more information? Sometimes, during a meeting or seminar doctors will pick up "tips" without really knowing the coding qualifications of those offering the information.

Orthopaedic Coding Companions have been well worth the investment to me. I personally purchased both upper and lower companions and can not fathom how I lived without them!

Take Care,

Karen Gallagher, CPC, COSC
 
Thank you for your responses!! One of the surgeons is telling me it came from a NASS meeting that he went to, and I have not been able to touch basis with my other surgeon. In some of my research I did find a article written by Kristi Stumpf, MCS-P, CPC, COSC, ACS-OR. she is a senior orthopedic coder and auditor for The Coding Networ based in Beverly Hills, CA. She stated "For a fusion for spinal deformity (e.g., scoliosis or kyphosis), coders should look to codes 22800-22819. This code series was created for, and intended to be used for, fusion procedures performed on younger patients with congential spinal deformities, not for degenerative scoliosis, says Stumpf." This article is "Get the facts on spinal fusion, instrumentation and grafts, September 6, 2011

any thoughts
 
Check with your surgeon for his log in information for NASS. There is a coding and reimbursement section within that association that members have access to with their yearly dues.

Kristi Stumpf is an amazing educator and I have been to numerous seminars with her. Her wealth of knowledge is virtually endless.

Look carefully and read what she states "younger patients". This is a much broader category than "pediatric patients" (0-18 yrs.). Younger than what? Younger could be 30 years old, 22 etc. Perhaps, your surgeons interpreted younger to mean pediatric. I believe the intent was to ensure that this code was utilized for congenital anomalies, not degenerative changes. Could be wrong. Looking forward to hearing the answer.

I have reached out to my spine surgeons, but have not received a response. They are probably avoiding me thinking I audited them! LOL.

Now, my curiosity is killing me. I will post what I find, will you?
Karen Gallagher, CPC, COSC.
 
Karen, I will post anything I find. I will try to round up my surgeons next week and get someone's log in info for me. Help to know that Kristi is well known. And you are right about the younger vs peds patients. I read that as being younger in meaning under 18 and being considered peds.
Thanks
Stacey Delser CPC
 
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