67 spine surgeries CMS may remove from the inpatient-only list in 2021

Laura Dyrda -

CMS released the 2021 proposed payment rule for hospital outpatient departments and ASCs on Aug. 4.

The agency proposed removing 300 musculoskeletal procedure codes from the inpatient-only list over a three-year period, including 67 spine codes for 2021.

Below are the spine procedures CMS may remove from the inpatient-only list next year.

1. Removal of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure): 0095T

2. Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure): 0095T

3. Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (list separately in addition to code for primary procedure): 0163T

4. Removal of total disc arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure): 0163T

5. Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure): 0165T

6. Posterior vertebral joint(s) arthroplasty (for example, facet joint[s] replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, including fluoroscopy, single level, lumbar spine: 0202T

7. Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical: 0219T

8. Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic: 0219T

9. Application of halo, including removal; cranial: 20661

10. Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (for example, pediatric patients, hydrocephalus, osteogenesis imperfecta): 20664

11. Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral: 22015

12. Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical: 22110

13. Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic: 22112

14. Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar: 22114

15. Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure): 22116

16. Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); thoracic: 22206

17. Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); lumbar: 22207

18. Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure): 22208

19. Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical: 22210

20. Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic: 22212

21. Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar: 22214

22. Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure): 22216

23. Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical: 22220

24. Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic: 22222

25. Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar: 22224

26. Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure): 22226

27. Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar: 22325

28. Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical: 22326

29. Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic: 22327

30. Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure): 22328

31. Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic: 22532

32. Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar: 22533

33. Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure): 22534

34. Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic: 22556

35. Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar: 22558

36. Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace: 22586

37. Arthrodesis, posterior technique, craniocervical (occiput-c2): 22590

38. Arthrodesis, posterior technique, atlas-axis (c1-c2): 22595

39. Arthrodesis, posterior or posterolateral technique, single level; cervical below c2 segment: 22600

40. Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed): 22610

41. Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar: 22630

42. Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (list separately in addition to code for primary procedure): 22632

43. Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments: 22800

44. Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments: 22802

45. Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments: 22804

46. Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments: 22808

47. Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments: 22810

48. Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments: 22812

49. Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments: 22818

50. Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments: 22819

51. Exploration of spinal fusion: 22830

52. Internal spinal fixation by wiring of spinous processes (list separately in addition to code for primary procedure): 22841

53. Posterior segmental instrumentation (for example, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure): 22843

54. Posterior segmental instrumentation (for example, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure): 22844

55. Anterior instrumentation; 4 to 7 vertebral segments (list separately in addition to code for primary procedure): 22846

56. Anterior instrumentation; 8 or more vertebral segments (list separately in addition to code for primary procedure): 22847

57. Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure): 22848

58. Reinsertion of spinal fixation device: 22849

59. Removal of posterior nonsegmental instrumentation (for example, harrington rod): 22850

60. Removal of posterior segmental instrumentation: 22852

61. Removal of anterior instrumentation: 22855

62. Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar: 22857

63. Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical: 22861

64. Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar: 22862

65. Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical: 22864

66. Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical: 22865

67. Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed: G0412

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