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Wiki 00630 vs 00670

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chase0702

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One of our providers is using CPT 00630 RV8 for a lumbar microdiscectomy. Can we actually bill with CPT 00670 RV13? Thank you
 
00630 is appropriate for a lumbar microdiscectomy unless the documentation supports the extensive procedure requirement for code 00670. For this procedure that usually means instrumentation was used or multiple levels were operated on. Unfortunately, there is no concrete definitio of "extensive." Whatever the reason for using 00670, make sure the documentation backs it up.
 
00630 vs -00670

I have to agree with "gost". 00670 is reserved for instrumentation or multiple levels. We ask our docs to provide the documentation to support using 00670 What we normally see in the documentation is Lumbar Lami @ L4/5, L5/S1 (this would constitute multiple levels= 00670). Or we see Lumbar Lami with Instrumentation (this also qualifies for 00670). If we only see Lumbar Lami @ l5/S1 it is straight on 00630. If there is any doubt, we request the operative report. Our auditor has told us that anything more than one level is extensive spinal surgery.
 
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