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ICD-10 Guide
ICD-10 CodesM43.24

M43.24

Billable

Fusion of spine, thoracic region

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M43.24 is a billable code used to indicate a diagnosis of fusion of spine, thoracic region.

Key Diagnostic Point:

Fusion of the thoracic spine is a surgical procedure aimed at stabilizing the vertebrae in the thoracic region of the spine, which is crucial for maintaining structural integrity and preventing deformities. This procedure is often indicated for patients with spinal deformities such as scoliosis, kyphosis, or lordosis, where abnormal curvature of the spine can lead to pain, respiratory issues, or neurological deficits. The fusion process involves the use of bone grafts and instrumentation to promote bone healing and stability. The thoracic spine consists of 12 vertebrae, and fusion may involve one or more of these vertebrae. The surgical approach can vary, including posterior, anterior, or lateral techniques, depending on the specific condition being treated. Post-operative care is essential for recovery, and patients may require physical therapy to regain strength and mobility. Complications can include infection, non-union of the fusion, and adjacent segment disease, making careful patient selection and thorough pre-operative assessment critical.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in surgical techniques and approaches
  • Need for precise documentation of the specific vertebrae involved
  • Differentiation between types of spinal deformities
  • Potential for co-morbid conditions affecting the spine

Audit Risk Factors

  • Inadequate documentation of the surgical approach
  • Failure to specify the number of vertebrae fused
  • Lack of clarity on the underlying condition necessitating fusion
  • Inconsistent coding of related procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments are essential.

Common Clinical Scenarios

Patients with progressive scoliosis or kyphosis requiring stabilization.

Billing Considerations

Ensure documentation reflects the complexity of the case and any co-morbidities.

Neurosurgery

Documentation Requirements

Comprehensive neurological assessments and imaging to support surgical necessity.

Common Clinical Scenarios

Patients with neurological deficits due to spinal deformities.

Billing Considerations

Document neurological evaluations and any intraoperative findings.

Coding Guidelines

Inclusion Criteria

Use M43.24 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the procedure, including the specific vertebrae involved and the underlying condition

Exclusion Criteria

Do NOT use M43.24 When
  • Exclude codes that do not pertain to surgical fusion or that represent different spinal conditions

Related ICD-10 Codes

Related CPT Codes

22610CPT Code

Posterior spinal fusion

Clinical Scenario

Used in conjunction with M43.24 for surgical intervention.

Documentation Requirements

Operative report detailing the procedure and vertebrae involved.

Specialty Considerations

Orthopedic surgeons must document the surgical approach and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spinal conditions, improving the accuracy of data collection and reimbursement processes. M43.24 provides a clear designation for thoracic spine fusion, enhancing the ability to track outcomes and complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spinal conditions, improving the accuracy of data collection and reimbursement processes. M43.24 provides a clear designation for thoracic spine fusion, enhancing the ability to track outcomes and complications.

Reimbursement & Billing Impact

reimbursement processes. M43.24 provides a clear designation for thoracic spine fusion, enhancing the ability to track outcomes and complications.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons

Frequently Asked Questions

What conditions typically require thoracic spinal fusion?

Conditions such as severe scoliosis, kyphosis, and trauma-related instability often necessitate thoracic spinal fusion to stabilize the spine and alleviate symptoms.