XNH7358
Insertion Pelvic Bone, Left to New Technology Group 8 with Internal Fixation Device with Tulip Connector, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | X New Technology |
| Body System | N Bones |
| Operation | H Insertion |
| Body Part | 7 Pelvic Bone, Left |
| Approach | 3 Percutaneous |
| Device | 5 Internal Fixation Device with Tulip Connector |
| Qualifier | 8 New Technology Group 8 |
Operation Definition
Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part
Procedure Overview
This family involves placing a nonbiological device onto or into a bone that monitors or supports a physiological function without replacing any bone itself, such as a sensor-equipped fixation component used to track healing, pressure, or load at a fracture or fusion site. Unlike a bone graft or joint replacement, nothing about the bone's structure is being substituted; the device is an add-on tool that gathers information or performs a supporting function while the bone remains the body's own. This kind of technology is generally used alongside a primary orthopedic procedure, such as a spinal fusion or fracture fixation, to give the surgical team ongoing feedback about how the area is healing or bearing weight. For patients, it is usually explained as an extra layer of monitoring built into hardware they were already going to receive, rather than a separate implant decision.
Anatomy & Axis Detail
Pelvic Bone, Left
The left pelvic bone, formed from the fused ilium, ischium, and pubis, plays the same weight-bearing and stabilizing role as its right-sided counterpart, transmitting load between the spine and the lower limb through the hip and sacroiliac joints. Insertion of a new-technology device here is typically undertaken for severe fracture, bone loss around a failing hip implant, or a structural defect following tumor removal, with the device intended to promote bone healing or provide localized biologic support rather than replace the bony architecture. The pelvis's irregular shape and proximity to pelvic organs and major vessels require careful planning distinct from insertion into long bones. Because laterality changes the surgical approach and any related hip or sacroiliac involvement, the record should clearly identify the left side and the specific pelvic subsite treated to keep it distinct from right-sided or contralateral procedures.
Approach: Percutaneous
In New Technology, Percutaneous describes entry into the body via needle or instrument puncture through the skin or a mucous membrane, without a surgical incision, mirroring the same concept in Medical and Surgical. It is distinguished from Open access, which requires a full incision, and from Percutaneous Endoscopic, which adds visualization through the puncture site.
Device / Substance / Technology: Internal Fixation Device with Tulip Connector
This value identifies an internal spinal fixation device that uses a tulip-shaped connector to secure a rod to a vertebral anchor, commonly part of posterior tethering or fixation constructs used in scoliosis correction. It is distinguished from other internal fixation hardware by this specific tulip connector design, which allows angular adjustment and secure rod capture. The component works alongside tether or rod systems rather than functioning as a standalone implant.
Qualifier: New Technology Group 8
Group 8 identifies technologies added to the New Technology section for the 2021-2022 update cycle, tying a given code to that specific approval year. The underlying substance, device, or technique is defined by the other six axis positions, not by the group number itself. Because group numbers simply track chronology, Group 8 differs from Group 7 and Group 9 only in when CMS granted the technology separate recognition.
Coding & Documentation
Coders need documentation that names the specific device and describes its monitoring or assistive function, since New Technology Insertion codes require identifying the exact system rather than just noting that hardware was placed in bone. The note should make clear the device does not physically substitute for any bone that was removed, and should specify the bone and region involved. A common mistake is bundling the sensor or monitoring component into the fixation device code without separately capturing the New Technology insertion, or applying this code when the device is simply a standard fixation screw or plate with no monitoring or assistive function.
Commonly Confused With
This family is frequently confused with standard Insertion of internal fixation devices, which are coded in the Medical and Surgical section and do not carry a monitoring or assistive function; the distinguishing feature is whether the hardware actively senses or supports a physiological process versus purely providing mechanical stability. It should also be separated from Replacement procedures involving synthetic or structural bone substitutes, since those substitute for bone rather than simply monitoring it, and from bone growth stimulator placements reported elsewhere if the specific device does not meet New Technology criteria.