63012 denial w/coventry
in some cases it does. here is an example of the CPT codes we used & note:
22633,22842,63047,63012,22634,63048
pt had spoldylolisthesis on L3-L5
pt had stenosis on L3-L5
pt had L3-4 disk herniation & DDD
The Gill decompressions were then performed at 12?4 and L4-5. The bone was carefully cleated of soft tissue in preparation for harvesting for autograft. The bone was then removed. The spinous process of L3 and L4 were then removed using the Leksell rongeur. The underlying lamina and medial facets were removed using the Leksell rongeur and Kerrison punches. Foramiriotomies were performed bilaterally at L3-4 and L4-5 decompressing the L3, L4, and L5 nerve roots bilaterally. Ligament was carefully dissected away from the underlying dura as well.
The interbody fusions were then performed. Epidural veins were coagulated and divided. The retractor was applied. This was performed at L3-4 and L4-5. The disk spaces were incised bilaterally using a 15 blade. The MTF PLIF system was utilized. Disk material and cartilaginous endplate were mobilized using shavers and curettes and then removed back to solid endplate. Trials were placed, first in L3?4, and a 15 mm trial was optimal. Therefore, 15 mm MTF PLIF spacers were selected and inserted using the bone tap and mallet. The previously harvested autograft was morselized and packed in between the 2 grafts.
The same process was repeated at L4-5. The 13 mm spacers were applied, and then 13 mm MTF PLIF spacers selected and tapped in using the bone tapping mallet, Again, autograft was packed in between the 2 grafts. All grafts entered with excellent purchase.
The posterolateral fusion was then performed. The transverse processes of L3, IA, and L5 were decorticated bilaterally, and more of the previously harvested autograft was packed in along these transverse processes.
The posterior spinal instrumentation was then performed. The Depuy EXPEDIUM System was utilized. The entry points were selected using anatomic pedicle screw, and entry points were selected using anatomic landmarks and decorticated with the drill. The pedicle finder was passed, followed by a feler, followed by a 5 mm tap, followed by a 6.0 x 45 mm screw. This was performed bilaterally at L3, L4, and L5. All screws entered with excellent purchase. The screws were connected with lordotic rods and secured using the locking nuts, which were then tightened with the torque wrench and antitorgue device. Gentle compression was performed across the L3?4 and L4-5 segments, An x?ray at this point confirmed excellent position of the bone grafts with good distraction, good alignment, and excellent position of the instrumentation.