Estimating Intraoperative Neurophysiological Monitoring Rates for Anterior Cervical Discectomy and Fusion: Are Diagnostic or Procedural Codes Accurate?

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Figure
Distribution of which out of 15 International Classification of Diseases-9 (ICD-9) columns the intraoperative neurophysiological monitoring (IONM) code (N = 17,606) was in among anterior cervical discectomy and fusion hospitalizations from 2009 to 2013 (N = 152,735) included in the Nationwide Inpatient Sample database.

Table 1

ICD-9, ICD-10, and CPT procedure codes for ACDF and IONM.

ACDF, anterior cervical discectomy and fusion; CPT, Current Procedural Terminology; ICD-10, International Classification of Diseases, 10th Revision; IONM, intraoperative neurophysiological monitoring.

Table 2

Estimatedhan CPT coding, and the discrepancy from actual I rates of institutional IONM usage for ACDFs.

ACDF, anterior cervical discectomy and fusion; CPT, Current Procedural Terminology; ICD, International Classification of Diseases; IONM, intraoperative neurophysiological monitoring.

Table 3

Estimated rates of national IONM usage for ACDFs.

Source	Dates	ACDF Coding	IONM Coding	Hospitalizations	IONM Usage
NIS	2009–2013	ICD-9¹⁵	ICD-9⁵	152.735	10,934 (7.2%)
NIS	2009–2013	ICD-9¹⁵	ICD-9¹⁵	152,735	17,606 (11.5%)
NIS	2014 to 30 September 2015	ICD-9¹⁵	ICD-9⁵	50,601	5,538 (10.9%)
NIS	2014 to 30 September 2015	ICD-9¹⁵	ICD-9¹⁵	50,601	9,296 (18.4%)
National Surgical Quality Improvement Program	2014–2017	CPT	CPT	43,262	327 (0.76%)

Note: IONM use in the NIS database was assessed using either the first 5 procedure code columns (designated as ⁵) or all 15 columns (designated as ¹⁵).
ACDF, anterior cervical discectomy and fusion; CPT, Current Procedural Terminology; ICD-9, International Classification of Diseases, 9th Revision; IONM, intraoperative neurophysiological monitoring; NIS, Nationwide Inpatient Sample.