Wiki Coding Bilateral Revision Laminectomy

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chankim

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I'm always confused by laminotomy and laminectomies because the difference is minor.

Is the best code for a revision bilateral laminectomy, 63042??

or is there another code? What is the techincal difference between the two??

My doctor says that a lamniectomy is just a larger sized laminotomy
 
It depends on the intent and diagnosis. 63042 is for recurrent disc herniation.

"is used when the diagnosis is recurrent herniated disc and a re-do discectomy is performed outside the post-operative global period of the initial discectomy."

 
thanks for the response.

So this is what is stated in OP notes:

Complex revision decompressive laminectomy was performed at levels of S1 and L5 and L4. Micro Kerrison Rongeurs were used in this revision. Extensive lysis of adhesions off of dura and nerve roots was performed. This was done extremely slowly with attention to detail.

Complex primary decompressive laminectomy was performed at levels of L3 and L2 with micro kerrison rongeurs. Dense adhesions were seen to the dura and lysis of adhesions was performed with micro neuro instruments.


*The main procedure is a posterior spinal fusion
 
You're welcome. If it wasn't for a re-herniation of a disc that had a hemi done prior, even if it was done during the course of a new PSF, it's 63052 if done for decompression. Sounds like he's looking for a 22 mod too by saying complex but unless there is more info to support a 22, can't add. Would need to see the diagnoses and more info of report. I guess if it was adhesions, etc. causing the issue it *might* be ok to report 63042 but not sure because that's normally only tied to re-herniation.
 
Got it. But the Dr. is now saying it was a bilateral procedure which I am pushing back on because it was clearly documented.

The Dx are: lumbar stenosis, spondylosis, and DDD w/ prior lumbar fusion and laminectomy.
 
That wouldn't really matter for 63052 because it has unilateral or bilateral in the description so you can't code a 50 mod. 50 is applicable to the 63042 area. It if was done bilaterally, it should be called out but it won't get a 50.
Also read the info in the CPT book around this family of codes there are parenthetical notes directing us how to code these. Specifically if decompression is performed during interbody fusion and about bilateral reporting.
 
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