--- title: "Spinal Fusion Coding: Identifying the Column Being Fused" description: When coding a spinal fusion record, the operative report should be reviewed to determine if the fusion is being performed on the anterior or the posterior column of the spine, or even both. Let’s look at what this means. image: https://hiacode.com/hubfs/Imported_Blog_Media/iStock-983383674-1.jpg --- # Spinal Fusion Coding: Identifying the Column Being Fused ![HIAcode](https://hiacode.com/hubfs/Logos/HIA_RGB_PrimaryLogo_Icon%20(1)_Artboard%201.png) [HIAcode](https://hiacode.com/blog/author/hiacode) Jun 24, 2024 [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) ![Spinal Fusion Coding — Identifying the Column Being Fused](https://hiacode.com/hubfs/Imported_Blog_Media/iStock-983383674-1.jpg) - Share on: - [![](https://hiacode.com/hubfs/Facebook%20svg.svg)](http://www.facebook.com/share.php?u=https://hiacode.com/blog/education/identifying-the-column-being-fused) - [![](https://hiacode.com/hs-fs/hubfs/twitter.png?width=32&height=32&name=twitter.png)](https://twitter.com/intent/tweet?text=I+found+this+interesting+blog+post&url=https://hiacode.com/blog/education/identifying-the-column-being-fused) - [![](https://hiacode.com/hubfs/LinkedIn%20svg.svg)](http://www.linkedin.com/shareArticle?mini=true&url=https://hiacode.com/blog/education/identifying-the-column-being-fused) - [![](https://hiacode.com/hubfs/mdi_email.svg)](mailto:?subject=Check%20out%20https://hiacode.com/blog/education/identifying-the-column-being-fused%20&body=Check%20out%20https://hiacode.com/blog/education/identifying-the-column-being-fused&media=https://20824215.fs1.hubspotusercontent-na1.net/hubfs/20824215/Imported_Blog_Media/iStock-983383674-1.jpg) - ![](https://hiacode.com/hubfs/entypo_link.svg) copied When coding a spinal fusion record, the operative report should be reviewed to determine if the fusion is being performed on the anterior or the posterior column of the spine, or even both.  ## Anterior Column The anterior part of the spinal column refers to the side of the spine that faces the front of the body. If the fusion being coded is described as interbody or has documentation of insertion of an interbody fusion device/cage that means that the anterior side of the spinal column is where the fusion is taking place. Anterior column is not the same as anterior approach. ## Posterior Column The posterior part of the spinal column refers to the side of the spine that faces the back of the body. This is the side you can feel if you run your fingers over someone’s back. If the operative note describes insertion of bone graft along with rods and screws or decortication of the spinous processes this is in the posterior column. Other terms that indicate work on the posterior column are lamina, facet, articular process and transverse process. ![Posterior and Anterior Spinal Column ](https://hiacode.com/hs-fs/hubfs/Posterior%20and%20Anterior%20Spinal%20Column%20.png?width=560&height=306&name=Posterior%20and%20Anterior%20Spinal%20Column%20.png) Photo courtesy: [https://commons.wikimedia.org/wiki/File:722_Feature_Osteoprosis_of_Spine.jpg ](https://commons.wikimedia.org/wiki/File:722_Feature_Osteoprosis_of_Spine.jpg) ## Both Columns? Some patients have fusion of both sides of the spinal column. This is sometimes referred to as a 360degree fusion and may or may not require turning the patient, depending on the technique being used. ICD-10-PCS has different qualifier values for reporting anterior and posterior fusions, so if both sides of the spinal column are fused, separate codes will be needed to report each type of fusion (see ICD-10PCS coding guideline B3.10b) Coding Tip: Review documentation in the operative note carefully to identify if only one or both sides of the spinal column are fused as reporting both anterior and posterior fusion together results in a higher weighted DRG.  ![posterior column](https://hiacode.com/hs-fs/hubfs/posterior%20column.png?width=640&height=561&name=posterior%20column.png) Learn more about Spinal Fusion Coding by purchasing our *[Spinal Fusion Coding eBook](https://hiacode.com/resources/spinal-fusion).* ** * [![Spinal-Fusion-EBOOK-no-shadow](https://no-cache.hubspot.com/cta/default/20824215/interactive-162012988239.png) ](https://hiacode.com/hs/cta/wi/redirect?encryptedPayload=AVxigLJWsX5q5JFXYj0Tie3nSjO7riaCIO30Qwvgpt7MCI2fP%2BspAX2J%2FY%2FWi2rKg9Z%2BsKUhgZCbCav8oF7PfWI9Q%2Bwthj7X8R21%2B4BjuUDP2mL%2B5HQVU0QVj3DuiW5NIAr0EPTRATJkQEFff4uaGyPRNqF4gU%2B%2FGl%2F4IukhV3b1rot02WDercBFrh9FgFD4wV8%3D&webInteractiveContentId=162012988239&portalId=20824215) * * *   ***References*** *[mayfieldclinic.com/pe-anatspine.htm](https://mayfieldclinic.com/pe-anatspine.htm)* ### ![](https://hiacode.com/hs-fs/hubfs/Imported_Blog_Media/Kims-autograph-May-12-2022-06-56-00-67-PM.png?width=164&height=68&name=Kims-autograph-May-12-2022-06-56-00-67-PM.png) > ***The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.*** ##### [Previous](https://hiacode.com/blog/education/permanent-breast-implant-reconstruction) ### [Immediate Versus Delayed Breast Reconstruction with Permanent Implant](https://hiacode.com/blog/education/permanent-breast-implant-reconstruction) ##### [Next](https://hiacode.com/blog/education/icd-10-pcs-new-technology-code-for-bioengineered-human-acellular-vessel) ### [FY 2025 ICD-10-PCS: New Technology Code for Bioengineered Human Acellular Vessel](https://hiacode.com/blog/education/icd-10-pcs-new-technology-code-for-bioengineered-human-acellular-vessel) Serach Blog Post ## Need to Earn CEUs? Our coding education platform, HIAlearn.com, offers courses related to this topic and many more. Subscribe today and access more than 230 courses accepted by AHIMA for CEUs, with a selection also accepted by AAPC. ![CTA Sidebar HIAlearn logo-1](https://hiacode.com/hs-fs/hubfs/CTA%20Sidebar%20HIAlearn%20logo-1.png?width=1080&height=189&name=CTA%20Sidebar%20HIAlearn%20logo-1.png) [![Learn More](https://no-cache.hubspot.com/cta/default/20824215/f611164b-1c02-4b86-a2aa-6033633d4569.png)](https://cta-redirect.hubspot.com/cta/redirect/20824215/f611164b-1c02-4b86-a2aa-6033633d4569) #### Category - [Medical Coding Tips (370)](https://hiacode.com/blog/tag/medical-coding-tips) - [Industry News (339)](https://hiacode.com/blog/tag/industry-news) - [Company News (23)](https://hiacode.com/blog/tag/company-news) - [Query Tips (23)](https://hiacode.com/blog/tag/query-tips) - [Annual Code Updates (16)](https://hiacode.com/blog/tag/annual-code-updates) - [CDI Tips (9)](https://hiacode.com/blog/tag/cdi-tips) ### Subscribe to our Newsletter #### Recent Blogs Jul 01, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news) [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) ### [ICD-10-CM Coding for Colonosco...](https://hiacode.com/blog/icd-10-cm-coding-for-colonoscopy-following-positive-cologuard-result) Jun 24, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news) [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) ### [20,000 Inpatient Reviews Revea...](https://hiacode.com/blog/20k-inpatient-coding-reviews-principal-diagnosis-pcs-revenue-integrity) Jun 10, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news) [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) ### [Big Changes Coming to CPT Codi...](https://hiacode.com/blog/big-changes-coming-to-cpt-coding-for-maternity-care) Jun 05, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news) [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) ### [Why Being Proactive Matters in...](https://hiacode.com/blog/proactive-coding-quality-assurance) ## Related blogs from Medical Coding Tips Jul 01, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news),  [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) #### [ICD-10-CM Coding for Colonoscopy Following Positiv...](https://hiacode.com/blog/icd-10-cm-coding-for-colonoscopy-following-positive-cologuard-result) A colonoscopy prompted by a positive Cologuar... [ Read More](https://hiacode.com/blog/icd-10-cm-coding-for-colonoscopy-following-positive-cologuard-result) Jun 24, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news),  [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) #### [20,000 Inpatient Reviews Reveal Coding Opportuniti...](https://hiacode.com/blog/20k-inpatient-coding-reviews-principal-diagnosis-pcs-revenue-integrity) A review of 20,805 inpatient encounters found... [ Read More](https://hiacode.com/blog/20k-inpatient-coding-reviews-principal-diagnosis-pcs-revenue-integrity) Jun 10, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news),  [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) #### [Big Changes Coming to CPT Coding for Maternity Car...](https://hiacode.com/blog/big-changes-coming-to-cpt-coding-for-maternity-care) Beginning January 1, 2027, CPT will retire th... [ Read More](https://hiacode.com/blog/big-changes-coming-to-cpt-coding-for-maternity-care) Jun 05, 2026 [Industry News](https://hiacode.com/blog/tag/industry-news),  [Medical Coding Tips](https://hiacode.com/blog/tag/medical-coding-tips) #### [Why Being Proactive Matters in Coding Quality Assu...](https://hiacode.com/blog/proactive-coding-quality-assurance) Taking a proactive approach to coding quality... [ Read More](https://hiacode.com/blog/proactive-coding-quality-assurance) ## Subscribe to our Newsletter Weekly medical coding tips and coding education delivered directly to your inbox. ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "HIAcode", "url" : "https://hiacode.com/blog/author/hiacode" }, "dateModified" : "2024-06-24T16:00:42.294Z", "datePublished" : "2024-06-24T16:00:00.000Z", "headline" : "Spinal Fusion Coding: Identifying the Column Being Fused", "image" : [ "https://hiacode.com/hubfs/Imported_Blog_Media/iStock-983383674-1.jpg" ], "mainEntityOfPage" : { "@id" : "https://hiacode.com/blog/education/identifying-the-column-being-fused", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://hiacode.com/hubfs/HIA_RGB_AlternativeLogo%20(1)%20(1).png" }, "name" : "Health Information Associates" } } ```