Neurosurgery Coding Alert

Question: Would a diagnosis of acquired spondylolisthesis (738.4, Acquired spondoylolisthesis) be appropriate to use with open reduction codes 22325-22328? My doctors think an open reduction applies to this diagnosis. I thought the AANS [American Association of Neurological Surgeons] stated that the condition is not considered a fracture or a true dislocation.

California Subscriber

Answer: The diagnosis of acquired spondylolisthesis (738.4) typically applies to patients who develop a degenerative anterolisthesis, usually at L4-L5 in the lumbar spine. The CPT codes 22325-22328 are used to describe fracture/ dislocation treatment reflecting an underlying injury. The fracture and dislocation ICD-9 codes would typically be the clinical indication for performing these procedures, not an acquired degenerative spondylolisthesis.