Wiki Dural Repair

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Is a dural repair separately billable when performed with a spinal fusion, lumbar decomprssion? The dural repair was done during the decompression. Thanks.
 
Dural repair

Typically no because the dura should not be opened during a lumbar decompression. If the dura is opened it's usually because of a complication (eg, incidental durotomy or dural tear). Therefore, repair of something you inadvertently did during the procedure is not separately billable.

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com
 
Is a dural repair separately billable when performed with a spinal fusion, lumbar decomprssion? The dural repair was done during the decompression. Thanks.
Dural repair

Typically no because the dura should not be opened during a lumbar decompression. If the dura is opened it's usually because of a complication (eg, incidental durotomy or dural tear). Therefore, repair of something you inadvertently did during the procedure is not separately billable.

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com
I had a question in this regard.

I understand that dural repair is not separately billable because it is incidental to the Surgery. Can we bill modifier 22 because of the durotomies?

Doctor did an ACDF (Anterior Cervical Discectomy and Fusion) and noted the following complication.
Durotomy X2; given the adherence of the disc to the dura the patient during decompression suffered two durotomies.

Can we add modifier 22 to 22551 and 22552? And should we add a diagnosis code for the complication?
 
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