63030 and 22612 at the same level

0913@70

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Can fusion and hemilaminectomy w/foraminotomy and facetectomy be billed at the same level L4-L5 (63030 and 22612 code)? I don't think so, but would like to get other opinions.

Thank you
 

moodymom

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They are not inclusive to each other...it has been in my experience that you should have strong documentation of decompression of neural elements or discectomy. Cpt guides you to report them separately when performed.
 
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EncoderPro

Good morning!

I double checked EncoderPro, and it states: "According to CCI Guidelines, these 2 codes may be billed together."

I also checked this grouping against the NASS Coding Conference materials from February 2012. According to Dr. Karin Swatz's lecture, these can be billed together. She also advised for appropriate use of modifiers (-51, and -59).

Hope this additional information is helpful!

Mary Corkins
TRG
maryc@trgltd.com
 
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