Q:  You covered all of the devices in the fusion tables except synthetic substitute.  When would this device be used?

A:  Fusion of the spine with a synthetic substitute is extremely rare since some type of bone graft is used to “glue” the joint together.  The device value for synthetic substitute may be used if synthetic bone replacement material is used (i.e., neither autologous nor nonautologous).

Q:  How do you code for a 360-degree fusion?

A:  There are various ways to code for a 360-degree fusion, depending on the devices used and the approach to each spinal column.  Coding of multiple spinal fusions, including 360-degree spinal fusion will be covered in our March webinar.

Q:  In the Insertion tables for the upper and lower joints, there is a device for Spinal Stabilization Device, Pedicle-Based.  If we are not to code for placement of pedicle screws in spinal fusion, when would this be used?

A:  The placement of pedicle screws and rods is included in spinal fusion because they are placed to hold the joint in place until the bone graft heals and permanently fuses the joint. Placement of a pedicular dynamic stabilization system is an alternative to spinal fusion in the treatment of degenerative disc disease.  In this procedure, the pedicle screws are placed without fusing the joint.

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