Table 1 CPT and ICD-10 codes included in algorithm by combination of procedure and primary indication
Inclusion CPT Codes | Inclusion ICD-10 Codes (Require one or more three months prior to surgery) | Exclusion ICD-10 Codes (Three Months Prior to Surgery) |
|---|---|---|
A: Spinal Surgery for Lumbar Spinal Stenosis | ||
22224, 22533, 22558, 22586, 22612, 22614, 22630, 22632, 22633, 22800, 22802, 22804, 22808, 22810, 22857, 22862, 22867, 63005, 63011, 63012, 63017, 63047, 63048, 63056, 63087, 63088, 63090, 63091, 63102, 63103, 63170 | M48.00, M48.061, M48.062, M48.07, M48.08 | G83.4, R15*, S32.0*, N31*, C41.2, M48.56*, M84.58*, R32, M48.46*, M84.48*, M84.40*, M84.60*, M48.57*, S22.08* |
B: Spinal Surgery for Lumbar Herniated Disc | ||
22224, 22533, 22558, 22586, 22612, 22614, 22630, 22632, 22633, 22800, 22802, 22804, 22808, 22810, 22857, 22862, 22867, 62287, 63005, 63011, 63012, 63017, 63030, 63035, 63042, 63047, 63048, 63056, 63087, 63088, 63090, 63091, 63102, 63103, 63170 | M51.06, M51.16, M51.17, M51.26, M51.27, M51.36, M51.37, M47.16, M47.26, M47.27 | G83.4, R15*, S32.0*, N31*, C41.2, M48.56*, M84.58*, R32, M48.46*, M84.48*, M84.40*, M84.60*, M48.57*, S22.08* |
C: Hip Arthroplasty for Hip Osteoarthritis | ||
27125, 27130, 27132 | M16.0, M16.10, M16.11, M16.12, M16.2, M16.30, M16.31, M16.32, M16.4, M16.50, M16.51, M16.52, M16.6, M16.7, M16.9 | M84.459*, M84.559*, S72.0*, S32.4*, M87*, M80*, M84.359*, M84.58*, S72.1*, S72.2*, C79.51, M84.30*, M84.40*, M84.48*, M84.50*, C41.4, C41.9 |
D: Knee Arthroplasty for Knee Osteoarthritis | ||
27438, 27440, 27441, 27442, 27443, 27445, 27446, 27447 | M17.0, M17.10, M17.11, M17.12, M17.2, M17.30, M17.31, M17.32, M17.4, M17.5, M17.9 | M80*, M87*, C79.51, C41.9 |