Laminectomy

How would bilateral L3, L4, L5, S1 laminectomies be coded? Would you code as 63047, 63048 x2 or 63047 63048 x3.

Laminectomies

Always review the CT Myelo to confirm the stenosis level. If this is a virgin surgery and all levels are confirmed for decompression, I would code 63047, 63048 X 3 units.

Laminectomy

Actually if only laminectomies were performed then you would code this as 63017.

However, if foraminotomies were also performed to decompress the nerve roots (usually due to stenosis) then you would choose the number of codes based on the levels of foraminotomies. Example, if laminectomies and foraminotomies to decompress nerve roots at L3-4, L4-5 and L5-S1 were performed, then you'd code 63047 and 63048 x 2.

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com

laminectomies

kim, Let me make sure I understand correctly. The procedures were laminectomies and foraminotomies and they way the report reads is bilateral laminectomiesand foraminotomies at L2, L3, L4, L5 and the report also states bilateral L2-L3, L3-L4, L5-S1 decompression so the coding would be 63047, 63048 x 2 correct? Thanks

Laminectomy

Check the operative report to see if there was also decompression at L4-L5 (you don't state that level in your note) because it's likely that the surgeon also did decompression there. So code based on the levels of decompression. So L2-L3 = 63047, L3-L4 = 63048, L4-L5 = 63048 and L5-S1 = 63048.

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com