The increase in less invasive spine procedures has resulted in some confusion, among surgeons and payers alike, regarding accurate coding and payment, for these nontraditional spine approaches. Approach does matter.
Codes are valued (and paid) based on the amount of physician work, both time and intensity. Different approaches — a small incision vs. a puncture vs. a conventional open incision — translate to different work effort and, therefore, different payment. The Figure summarizes the most common approaches to spine surgery, how each is defined and how each is accurately coded.