Q&A: Distinguish between segmental and non-segmental spinal instrumentation

Q: What is the difference between segmental and non-segmental spinal instrumentation?  

A: Segmental instrumentation is defined in the CPT Manual as involving "fixation at each end of the construct and at least one additional interposed bony attachment." For example, if the surgeon inserts a rod, the rod will have attachments to the spine at its top and bottom ends and at least one other place between.

Non-segmental instrumentation in CPT is defined as “fixation at each end of the construct.” For example, a rod that is only attached to the spine at its top and bottom ends.

Most often, when surgery spans multiple levels of the spine, the surgeon will use segmental instrumentation. If the procedure requires the insertion of instrumentation between two vertebrae, non-segmental instrumentation will be used.

Editor’s note: This question was answered by Lynn Anderanin CPC, CPMA, CPPM, CPC-I, COSC, senior director of coding education at Healthcare Information Services in Park Ridge, Illinois.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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