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Neurosurgery Coding Alert

Reader Question:

Get Specific for Instrumentation and Grafts in Spinal Procedures

Published on Wed Oct 03, 2012

Question: Our surgeon did the following procedures using the posterior thoracolumbar approach:"Open reduction of L1 burst fracture; T12, L1, L2 pedicle screw segmental instrumentation for stabilization; T12-L2 posterolateral arthrodesis using cancellous allograft bone chips and DBM putty."Below is how the operative note reads:"...posterior elements of T12, L1 and L2 were exposed. Using the DePuy EXPEDIUM system, we inserted 7.0 x 50 screws at T12 bilaterally as well as L2 bilaterally and 7.0 x 45 screws at L1 bilaterally. We went ahead and connected two appropriate size rods and final tightened set screws on there to complete the T12-L2 stabilization and in the process reduction of the L1 burst fracture.  .....then decorticated the posterior elements of T12, L1and L2 using a high-speed match stick drill.  We then went ahead mixed allograft cancellous bone chips with DBM putty and laid it on the posterior element to complete the T12, L1, L2 posterior arthrodesis. [...]
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