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Lumbar Fusion - One Level

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81150 CAFB

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I just want to see if I understand the regs properly - please correct me if I am reading it wrong. I had a diskectomy just over three months ago and never got better. Recent post-op Myleogram showed same disk reruptured again on both sides so I had a fusion at the L4-L5 level. If I am reading the regs correctly... the compensation is still based on range of motion (pain of motion) and not ankylosis since the entire lumbar section is not fused. Is this correct? Doesn't the fusion automatically limit ROM (two weeks post-op- definately does)? Any back fusion people on the site- how are you doing long- term?

Thanks for any replies.

81150 CAFB

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Had L5-S1 fusion in 2/2004. Painful recovery---takes about a year. Severe back pain gone. Still have pain/stiffness--though. Rated 20% for back, plus 10% left leg/foot radiculopathy/sciatica. Now have upper back/cervical neck pain, stiffness. Even though I worked in an office---I retired one year after fusion surgery. Can't sit long, can't stand long. Was irritable most of the time at work. I decided to take 30 year retirement at age 55---should have filed for disability ret. but did not. However, I did site my repeated back pain as a factor in my decision to retire. Currently I try to swim 3-5 days per week at local YMCA, which helps. I have avoided narcotics and elected high dose ibuprofen instead.

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  • HadIt.com Elder

A high dose of Ibuprophen can hurt more than narcotics. Except for being high and getting addicted naroctics won't kill you, but the Ibuprophen use over long period can burn holes in your guts.

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I feel lucky so far. The fusion appears to have worked- I just need to take it easy for another month. Still in a lot of pain with no BLT (bending, lifting or twisting) allowed. Looking at the regs posted... It appears that it is all based on ROM and nothing automatic for a fusion unless entire lumbar section is fused. So I will basically submit under IVDS like I was going to do after my initial diskectomy 3 months ago. Wonder what the code 5241 spinal fusion is used for- seems like rating for entire ankylosis of lumbar. I guess IVDS is the catch all and tied to range of motion...seems like it needs updating.

I am currently taking hydrocodone and flexeral, but am only two weeks post- op.

Thanks for responding.

Sorry to hear that some fusions didn't take.

81150

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  • HadIt.com Elder

5241 is correct. remember the regs changed. The less ROM the higher the rating. Post fusion is rated as traumatic arthritis. Ivds is used for active disk problems.

If it applies to you, Also go for the radiculpathy or effected nerves which are supposed to be rated separately.

J

Edited by jbasser
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How do they rate 5241- ROM? Is there an automatic rating for traumatic arthritis? I am confused... Just using different codes but the final rating is based on ROM?

I will definately have the nerves listed (both sides).

Thanks J... You helped me a lot when I first had my diskectomy 3 months ago.

81150

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