Wiki Laminectomies

[tldixon@mokancomm.net]

I need some help with this op report:
PROCEDURE:
L1 percutaneous kyphoplasty
L2-3, L3-4, L4-5 laminectomies with bilateral foraminotomies over the L3, L4, and L5 nerve roots.
Posterolateral L4-5 arthrodesis with application of local bone graft and Mozaik bone graft substitute.
Left iliac crest bone marrow aspirate
Here's what I have put together:
22524
22612
22614
63030,50,59
63035,59
38220,59
20936
Thanks for any help I can get...

 

[caromissunc1]

L1 Kypho- 22524 & 72291-26
L2-3 Lami- 63047 (If Medicare pt., PQRI is required for 63047)
L3-4 Lamis- 63048 (Also check for facetectomies. They are usually included & must be for this code.)
L4-5 Lami- 63048 w/ 59 mod. (This is allowable w/ an arthrodesis code ONLY if it is stated that it is for decompressive purposes ONLY! Usually a code of 724.02 or 724.03 (lumbar stenosis) accompanies this.)
L4-5 Arthrodesis- 22633
W/ Instrumentation- 22840
Interbody Fusion- If local bone graft (such as from the resected spinous processes) in same incision- 20936. (This may or may not fly depending on your payer.)
Iliac Crest Aspirate (You may code this out separately ONLY if it is taken from a separate incision!!!)- 38220- 59

 

[tldixon@mokancomm.net]

I appreciate your help on this one....