Neurosurgery Coding Alert

Question: One of our physicians performed a partial corpectomy at T-11 and a partial corpectomy at T-12, but I-m not sure how to report this. Should I report a corpectomy and an additional level? If not, how should I code it?


South Dakota Subscriber

Answer: You didn't indicate in your question whether the neurosurgeon performed the corpectomy for an intrinsic bony lesion or for decompression--and that affects your coding. If the procedure was for a bony  lesion, you should use 22112 (Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root[s], single vertebral segment; thoracic) with +22116 (... each additional vertebral level).
 
If the neurosurgeon used the corpectomy for decompression, however, you would use 63085 (Vertebral corpectomy [vertebral body resection], partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root[s]; thoracic, single segment) and +63086 (... thoracic, each additional segment).

You can take the CPT codes at face value when they indicate -partial or complete- and bill for a segment even though the amount removed is not extensive. However, if the physician does a minimal vertebral corpectomy in the course of an anterior diskectomy and decompression (e.g., removal of endplates), you cannot report the corpectomy separately.