Summary & Overview
Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without CC/MCC: Inpatient Reimbursement Overview
DRG 428 encompasses multiple level combined anterior and posterior spinal fusion procedures except cervical when no Major Complication or Comorbidity or Complication or Comorbidity is present. This classification defines inpatient resource grouping for Medicare reimbursement and hinges on precise documentation of surgical approach and comorbidity severity.
DRG 428 Overview
DRG 428 covers multiple level combined anterior and posterior spinal fusion procedures outside the cervical region in inpatient admissions without Major Complication or Comorbidity and without Complication or Comorbidity. This Diagnosis-Related Group applies to complex thoracic and lumbar fusion surgeries that use both anterior and posterior approaches across multiple vertebral levels. It matters for Medicare payment because case classification into this group affects inpatient reimbursement relative to less extensive fusion procedures. Accurate coding and documentation of surgical approach and comorbidity status determine assignment to this Diagnosis-Related Group.