2024 ICD-10-CM Procedure Code XRGB0R7

Fusion of Lumbar Vertebral Joint using Custom-Made Anatomically Designed Interbody Fusion Device, Open Approach, New Technology Group 7

ICD-10-PCS Code:: XRGB0R7
ICD-10-PCS Code for:: Fusion Lum Jt w Cust Intbd Fus Dev, Open, New Tech 7
Is Billable?: Yes - Valid for Submission
Code Navigator:

XRGB0R7 is a billable procedure code used to specify the performance of fusion of lumbar vertebral joint using custom-made anatomically designed interbody fusion device, open approach, new technology group 7. The code is valid for the year 2024 for the submission of HIPAA-covered transactions.

Table of Contents

Code Information
PCS Table
Replacement Code
Clinical Classification
Diagnostic Related Groups Mapping
Other Similar Codes

XRGB0R7 PCS Table

In an PCS table each code is represented by up seven alphanumeric characters, with each character in the table respresenting different aspects of the procedure. In the table provided below, each row represents an individual character and includes information about the character's position, designation, label, and procedure notes. For this PCS table the procedure code is in the new technology section and is part of the joints body system, classified under fusion operation. The applicable bodypart for this procedure code is lumbar vertebral joint.

Position	Designation	Character	Label	Procedures Notes
1	Section	X	New Technology
2	Body System	R	Joints
3	Operation	G	Fusion	Involves: Joining together portions of an articular body part rendering the articular body part immobile
4	BodyPart	B	Lumbar Vertebral Joint
5	Approach	0	Open	Involves: Cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure
6	Device/Substance/Technology	R	Interbody Fusion Device, Custom-Made Anatomically Designed
7	Qualifier	7	New Technology Group 7

Revised 2024 ICD-10-PCS Code

XRGB0R7 was revised for the FY 2024, effective October 1, 2022.

Replacement Code

XRGB0R7 replaces the following previously assigned ICD-10-PCS code(s):

0SG00A0 - Fusion Lum Jt w Intbd Fus Dev, Ant Appr A Col, Open
0SG00A0 - Fusion Lum Jt w Intbd Fus Dev, Ant Appr A Col, Open
0SG00A0 - Fusion Lum Jt w Intbd Fus Dev, Ant Appr A Col, Open
0SG00A0 - Fusion Lum Jt w Intbd Fus Dev, Ant Appr A Col, Open
0SG00A0 - Fusion Lum Jt w Intbd Fus Dev, Ant Appr A Col, Open
0SG00AJ - Fusion Lum Jt w Intbd Fus Dev, Post Appr A Col, Open
0SG00AJ - Fusion Lum Jt w Intbd Fus Dev, Post Appr A Col, Open
0SG00AJ - Fusion Lum Jt w Intbd Fus Dev, Post Appr A Col, Open
0SG00AJ - Fusion Lum Jt w Intbd Fus Dev, Post Appr A Col, Open
0SG00AJ - Fusion Lum Jt w Intbd Fus Dev, Post Appr A Col, Open

Clinical Classification

Clinical Category is Spine fusion
CCSR Category Code: MST013
Clinical Domain is Musculoskeletal, Subcutaneous Tissue, and Fascia Procedures - MST contains 30 categories that include procedures performed on the musculoskeletal, subcutaneous tissue, and fascia. Examples include hip arthroplasty, knee arthroplasty, spine fusion, and toe and midfoot amputation.

XRGB0R7 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together procedures for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on the primary procedure being performed. Once a patient is assigned a particular group, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care associated with a particular procedure. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The procedure code XRGB0R7 is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
028	SPINAL PROCEDURES WITH MCC	01	6.0261
029	SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS	01	3.4282
030	SPINAL PROCEDURES WITHOUT CC/MCC	01	2.319
453	COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC	08	8.8614
454	COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC	08	6.1163
455	COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC	08	4.6056
456	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC	08	8.4294
457	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC	08	6.0753
458	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC	08	4.531
459	SPINAL FUSION EXCEPT CERVICAL WITH MCC	08	6.6323
460	SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	08	3.6579
907	OTHER O.R. PROCEDURES FOR INJURIES WITH MCC	21	3.7195
908	OTHER O.R. PROCEDURES FOR INJURIES WITH CC	21	2.0041
909	OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC	21	1.3563
957	OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC	24	7.2325
958	OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC	24	4.0448
959	OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC	24	2.5324

Other ICD-10-PCS Codes Used for Fusion Lumbar Vertebral Joint

What is ICD-10-PCS?

The ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates. The 2024 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2023 through September 30, 2024.

Each ICD-10-PCS code has a structure of seven alphanumeric characters and contains no decimals. The first character defines the major "section". Depending on the "section" the second through seventh characters mean different things.