Selecting the Qualifier Values for Spinal Fusions: Three Basic Approaches
The qualifier values for spinal fusions further define the specific anatomical approaches used.
Three basic approaches are used for spinal fusions: anterior, posterior, and lateral. The anterior approach requires an incision in the neck or the abdomen, and the fusion is carried out at the front of the vertebrae. In the typical posterior approach an incision is made in the patient’s back directly over the vertebrae. The other approach is the lateral transverse which involves an incision into the patient’s side and the anterior of the vertebrae are approached this way.
Let’s take a closer look at the qualifier character for the root operation Fusion. This table shows fusion of the lower joints body system The qualifier value, character 7, defines the specific anatomical approach used for spinal fusion surgeries.
Let’s review one of these approaches.
Posterior Approach, Anterior Column (Value J)
In the posterior approach the spine is approached from the back and the fusion is done to the either the anterior part of the spine or the posterior part of the spine. Unlike the anterior approach which can only be used to fuse the anterior spine, a posterior approach can be used to fuse either the anterior or posterior spine which makes coding posterior approach fusions more difficult. You must read the report carefully to determine if the anterior or posterior spine was fused.
For a posterior approach and anterior column fusion look for:
Incision into the back directly over the spine or just to the side of the spine.
The patient being placed on the operating room table with the back up or in the prone position.
Interbody fusion with an incision through the patient’s back.
Also look for these techniques which are always posterior approach and anterior spinal column fusion:
Posterior Lumbar Interbody Fusion (PLIF) which is done with an incision in the back over the spine. Transforaminal Lumbar Interbody Fusion (TLIF) which is also done with an incision into the back.