| | --- |
| | title: Vertebro |
| | emoji: 🦴 |
| | colorFrom: yellow |
| | colorTo: purple |
| | sdk: gradio |
| | sdk_version: 5.49.1 |
| | app_file: app.py |
| | pinned: true |
| | hf_oauth: true |
| | hf_oauth_scopes: |
| | - inference-api |
| | short_description: AI-driven spine billing and operative note analyzer |
| | --- |
| | |
| | # 🦴 Vertebro — Automated Spine CPT Billing & Operative Note NLP |
| |
|
| | **Live Demo:** [Vertebro (Hugging Face Space)](https://huggingface.co/spaces/Slaiwala/Vertebro) |
| | **Developed by:** Shubham Laiwala (Nazarian Lab, BIDMC) |
| | **Advisor:** Dr. Jason Pittman, Dr. Ara Nazarian |
| | **Version:** `v1.0 — CPT Logic Core: deterministic spine billing inference` |
| |
|
| | --- |
| |
|
| | ## 💡 Overview |
| |
|
| | **Vertebro** is an intelligent, rule-based NLP engine that automatically interprets *spine operative notes* and suggests the most relevant **CPT billing codes**, **modifiers**, and **rationales** — all while maintaining payer-aware logic (Medicare, BCBS, Aetna, etc.). |
| |
|
| | It’s built for: |
| | - **Research:** Rapid auditing of spine operative notes |
| | - **Billing validation:** Cross-checking documentation against CPT standards |
| | - **Clinical education:** Understanding how procedural phrasing drives billing logic |
| |
|
| | The underlying logic is **deterministic, explainable**, and optimized for cervical, thoracic, and lumbar spine cases. |
| |
|
| | --- |
| |
|
| | ## 🧠 Key Features |
| |
|
| | | Feature | Description | |
| | |----------|--------------| |
| | | **CPT Suggestion Engine** | Extracts primary and add-on CPT codes from free-text operative notes | |
| | | **Payer Logic** | Adjusts code and modifier recommendations for each payer | |
| | | **Multi-Region Support** | Recognizes cervical, thoracic, and lumbar levels | |
| | | **Explainable Outputs** | Every CPT code includes rationale and confidence score | |
| | | **Modifier Awareness** | Detects 22, 50, 58, 78, 79, 82, and laterality codes automatically | |
| | | **No PHI Retention** | Inputs are transient and never stored or logged | |
| |
|
| | --- |
| |
|
| | ## 🧩 How to Use Vertebro |
| |
|
| | 1. **Open the app:** [Vertebro on Hugging Face](https://huggingface.co/spaces/Slaiwala/Vertebro) |
| | 2. **Paste or type an operative note** (e.g., “Left-sided TLIF L4–L5 with pedicle screws and interbody cage; posterolateral fusion performed. Navigation used.”) |
| | 3. **Select the payer** (e.g., Medicare, BCBS, Aetna) |
| | 4. **Click “Submit.”** |
| | 5. **Review results:** |
| | - CPT suggestions |
| | - Descriptions |
| | - Rationales |
| | - Categories (fusion, instrumentation, graft, etc.) |
| | - Confidence levels |
| |
|
| | 💬 **Please feel free to test real-life, de-identified operative note examples** from your own cases. |
| | The more diverse the phrasing, the better we can evaluate the model’s robustness. |
| |
|
| | --- |
| |
|
| | ## 🔍 Example Operative Notes to Try |
| |
|
| | ### 1. Anterior Cervical Discectomy and Fusion (ACDF) |
| | Anterior cervical discectomy and fusion performed at C5–C6 and C6–C7. |
| | PEEK cages placed at both levels with anterior plate fixation. |
| | |
| |
|
| | --- |
| |
|
| | ### 2. Transforaminal Lumbar Interbody Fusion (TLIF) |
| | Left-sided TLIF L4–L5 with pedicle screws and interbody cage. |
| | Posterolateral fusion performed with local autograft. |
| |
|
| | --- |
| |
|
| | ### 3. Posterior Cervical Fusion with Instrumentation |
| | Posterior cervical fusion from C3–C5 with lateral mass screws and rods. |
| | Local autograft used for fusion. |
| |
|
| |
|
| | --- |
| |
|
| | ### 4. Hardware Removal |
| | Removal of posterior instrumentation at L2–L4. |
| | No reinstrumentation performed. |
| | |
| |
|
| | --- |
| |
|
| | ### 5. Decompression Only |
| | L3–L4 decompression with partial medial facetectomy and foraminotomy. |
| | Microscope used. |
| | |
| |
|
| | --- |
| |
|
| | ## 🧾 Feedback Workflow (Dr. Pittman) |
| |
|
| | Every time you use **Vertebro**, please: |
| | 1. Review the CPT output table. |
| | 2. Compare it with the *true billing sheet or expected codes*. |
| | 3. Provide **feedback** such as: |
| | - ✅ “Correct CPTs and rationale.” |
| | - ⚠️ “Partially correct — missing code X or modifier Y.” |
| | - ❌ “Incorrect — CPT Z should not appear.” |
| | 4. Optionally add notes on **phrasing not recognized** (e.g., “MIS lateral approach not detected”). |
| |
|
| | This feedback will be used to iteratively refine and retrain the rule logic and future ML models. |
| |
|
| | --- |
| |
|
| | ## 📈 Testing & Exploration Areas |
| |
|
| | | Region | Case Type | Focus | |
| | |--------|------------|--------| |
| | | Cervical | ACDF, CDA, Posterior Fusion | Fusion + anterior plating logic | |
| | | Thoracic | Decompression, Instrumentation | Mid-thoracic handling | |
| | | Lumbar | TLIF, PLIF, ALIF, Post-lat Fusion | Interbody vs posterolateral overlap | |
| | | Any | Revision, Hardware Removal | 22849, 22852, staged operations | |
| | | Multi-Level | Complex constructs | Code chaining: 22552, 22614 | |
| | | Graft / Instrumentation | Autograft, Allograft, Plate/Rods | Add-ons: 20936, 20930, 22842 | |
| |
|
| | --- |
| |
|
| | ## 📬 Contact |
| |
|
| | For questions, case feedback, or feature suggestions, please reach out to: |
| | **📧** `slaiwala@bidmc.harvard.edu` |
| | **👤** Developer: *Shubham Laiwala* |
| | **🏥** Affiliation: Nazarian Lab, BIDMC / Harvard Medical School |
| |
|
| | --- |
| |
|
| | ### 🩺 Short Summary (for Hugging Face “About” sidebar) |
| |
|
| | > **Vertebro** automatically suggests CPT codes from spine operative notes using a rule-based NLP engine. |
| | > Designed for research, billing validation, and clinical education. |
| | > *Feel free to test real, de-identified operative notes!* |
