DRG 453, 454 and 455 - Combined Anterior/Posterior Spinal Fusion

Published 07/02/2019

DRG 453 — Combined Anterior/Posterior Spinal Fusion with MCC
DRG 454 — Combined Anterior/Posterior Spinal Fusion with CC
DRG 455 — Combined Anterior/Posterior Spinal Fusion without CC/MCC

Each of Medicare Severity Diagnosis Related Group (MS-DRG) is defined by a particular set of patient attributes which include principal diagnosis, specific secondary diagnoses, procedures, sex and discharge status.

The logic for MS-DRGs 453, 454 and 455 comprises two lists: An anterior spinal fusion list and a posterior spinal fusion list. Assignment to one of the combined spinal fusion MS-DRGs requires that a code from each list be reported. The ICD-10-PCS procedure codes are shown in the table below.

ICD-10-PCS Anterior Spinal Fusion List
XRG1092 Fusion of cervical vertebral joint using nanotextured surface interbody fusion device, open approach, new technology group 2
XRG2092 Fusion of 2 or more cervical vertebral joints using nanotextured surface interbody fusion device, open approach, new technology group 2
XRG4092 Fusion of cervicothoracic vertebral joint using nanotextured surface interbody fusion device, open approach, new technology group 2

ICD-10-PCS Posterior Spinal Fusion List 
XRG6092 Fusion of thoracic vertebral joint using nanotextured surface interbody fusion device, open approach, new technology group 2
XRG7092 Fusion of 2 to 7 thoracic vertebral joints using nanotextured surface interbody fusion device, open approach, new technology group 2
XRG8092 Fusion of 8 or more thoracic vertebral joints using nanotextured surface interbody fusion device, open approach, new technology group 2
XRGA092 Fusion of thoracolumbar vertebral joint using nanotextured surface interbody fusion device, open approach, new technology group 2
XRGB092 Fusion of lumbar vertebral joint using nanotextured surface interbody fusion device, open approach, new technology group 2
XRGC092 Fusion of 2 or more lumbar vertebral joints using nanotextured surface interbody fusion device, open approach, new technology group 2
XRGD092 Fusion of lumbosacral joint using nanotextured surface interbody fusion device, open approach, new technology group 2

Reference: Final Rule at the Federal Register