Zirpoli9306
Contributor
Hello, I am having a problem with an insurance carrier regarding my corpectomies (63081). Our neurosurgeon does not and has never specified in the operative report the percentage of the vertebral body removed, but Oxford has been denying them stating that they are not substantiated by our operative report. (Our operative report usually reads "partial corpectomy was performed.....) I think it is because they are letting themselves go by AANS about the percentage of the vertebral body removed. I discussed this with the neurosurgeon who stated that the does not remove more than 50% of the vertebral body due to some stability issues and that also, 63081 description in the CPT coding book does not mention any percentage and such so he is indeed coding right and the medical director is wrong in denying this claim. I have a bunch of claims that have the same issue but only this one particular insurance carrier is denying them. Has anyone else had this problem? and if so, how do you get around it?
Thanks!
Thanks!