August 25, 2025

New Technology Coding: The FFX® Lumbar Facet Fixation System


Overview of the FFX Lumbar Facet Fixation System

Since the introduction of ICD-10, spinal fusions have been a topic among coders and auditors. When coding spinal fusions, we typically look for where the instrumentation was placed: pedicles (posterior column) or disc space (anterior column). New technology has been created to treat lumbar spinal stenosis and facet syndrome. This new technology is the Facet FIXation device (FFX). “The FFX®system, placed bilaterally through a posterior surgical approach and spanning and compressing the facet joint interspace, is designed to aid lumbar fusion through bilateral immobilization of the facet joints”. 


Since this device is not placed in the traditional spinal column locations, ICD-10-PCS does not currently have an accurate or complete PCS code for this type of fusion. Therefore, a new technology code was introduced for this procedure. 


Coding Clinic Guidance for FFX Procedures

In Coding Clinic fourth quarter 2024 pg 49, we are instructed to create a code from the XRG fusion of joints table, with a device value of E “facet joint fusion device, paired titanium cages” with the qualifier of A to indicate that this is new technology, group 10. 

Table outlining ICD-10-PCS new technology coding for the FFX lumbar facet fixation system


Kendra Adams, RHIT 

Senior Consultant, Audit at UASI

 

With a strong background in health information technology and ICD-10 coding, Kendra Adams serves as a Senior Consultant in Audit at UASI. She contributes clear, practical coding tips rooted in real-world audit work to help coders improve accuracy, documentation quality, and compliant code assignment. 


Works Cited

SPINEMarketGroup. (2022). FFX lumbar facet fixation. Available at https://thespinemarketgroup.com/ffx-lumbar-facet-fixation/


American Hospital Association. (2024). Fixation of lumbar facet joint. ICD-10-CM/PCS Coding Clinic, Fourth Quarter, 49.
Effective with discharges October 1, 2024. Available at https://www.findacode.com/newsletters/aha-coding-clinic/icd/fixation-lumbar-facet-joint-I114051.html

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