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M43.26

Billable

Fusion of spine, lumbar region

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A surgical fusion procedure of the lumbar spine (lower back) where vertebrae are permanently joined together to provide stability.

Coding Tips

  • •Verify the fusion is isolated to the lumbar region; if it extends to sacral region, use M43.27 instead
  • •Note the number of levels fused in documentation as this may affect treatment decisions and outcomes

Code Hierarchy

└M43Other deforming dorsopathies└M43.2Fusion of spine└M43.26Fusion of spine, lumbar region
└M43.26Fusion of spine, lumbar region

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