LigaPASS 2.0™ PJK Prevention System

This installment of “In the kNOW” will provide insight into the LigaPASS 2.0™ PJK Prevention System.  This is a type of vertebral tether and will be assigned a New Technology ICD-10-PCS code for FY2023.

This posterior tether is used to prevent proximal junctional kyphosis or PJK.  This is a condition that can occur after a patient has a spinal fusion and which can create a forward bending of the spine at the level just above the section that was fused as seen in the pictures below.

To position the tether, the spinous processes at several levels have holes drilled into them.  Then, a band is woven from side-to-side through the spinous processes. An additional band is threaded in the opposite direction and woven as well.  The bands actually go under the interspinous and supraspinous ligaments.  The bands are threaded through connectors which are located on the fusion rod.  Once the bands are secured, the appropriate amount of tension is applied, and the bands are then locked into the connectors as seen in this picture.

This type of tethering is different than the anterior tether which treats scoliosis.  That anterior tethering is done without fusion by exerting pressure to realign the spine.  This posterior tethering is used in conjunction with spinal fusions (scoliosis related or not) to augment the ligamentous complex of the posterior spine in order to reduce post-fusion proximal junctional kyphosis (PJK).  Any fusion performed would be coded in addition to this code.

Coding professionals may find this procedure documented in a variety of ways in a patient’s record.  For example, it may be called a spinal tether, ligament repair/augmentation, or ligamentoplasty of the posterior ligamentous complex.  When reviewing the Index entry (Supplement, Bursa and Ligament, Spine), coders are directed to use Posterior Vertebral Tether in New Technology.  Below is a picture of the PCS table for posterior vertebral tether coding.

A question coding professionals might have is “How do I know whether the procedure is on a upper or lower spine bursa or ligament?”.  The answer is use Appendix E which has the Body Part Definitions for ICD-10-PCS.  Once reviewed it will be easy to determine where the procedure took place as evidenced in this final picture.

 

Now you are In the kNOW!!

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About the Author 

Dianna Foley, RHIA, CCS, CHPS, CDIP is OHIMA's Education Coordinator. Dianna has been an HIM professional for over 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She previously served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati and holds RHIA, CHPS, CDIP and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and is a presenter on coding topics at the national, state, and regional levels. Dianna mentors new AHIMA members and also provides monthly educational lectures to coders and clinical documentation specialists.