I didn't know which code to go with 63030-50 or 63047 (or something else) so I decided to have someone else's imput. The diagnosis is an L2 burst fracture involving all 3 columns of Denis. The procedure is L1-L3 bilateral laminectomy.
Pt was laid prone with a midline incision to the lumbar spine. Incision was carried down thru the skin and subcutaneous tissue down to the paraspinal fascia. A retractor was then put in place, and a Bovie cautery was then used to incise thru the fascia, down thru the spinous processes and proceeded to dissection of the paraspinal musles off of the spinous processes, laminae, facet joints up to the transverse processes of L1 down to L4 as well as up to the rib head of T12 bilaterally. Retractors were then put in place at the top and bottom aspects. We obtained another lateral lumbar x-ray after having placed a small marker at the level of L2. Once we verified that we were at the adequate level, we proceeded to decompression. Initially the spinous processes were removed at L1, L2 and L3 using a Leksell rongeur. The high-speed drill was used to drill off part of the lamina down to a thin eggshell thickness at L1 , L2 and L3 and proceeded using the curved curettes and the rongeurs to complete our laminectomies at L1, L2 and L3.
Thanks for anyone's imput.
Pt was laid prone with a midline incision to the lumbar spine. Incision was carried down thru the skin and subcutaneous tissue down to the paraspinal fascia. A retractor was then put in place, and a Bovie cautery was then used to incise thru the fascia, down thru the spinous processes and proceeded to dissection of the paraspinal musles off of the spinous processes, laminae, facet joints up to the transverse processes of L1 down to L4 as well as up to the rib head of T12 bilaterally. Retractors were then put in place at the top and bottom aspects. We obtained another lateral lumbar x-ray after having placed a small marker at the level of L2. Once we verified that we were at the adequate level, we proceeded to decompression. Initially the spinous processes were removed at L1, L2 and L3 using a Leksell rongeur. The high-speed drill was used to drill off part of the lamina down to a thin eggshell thickness at L1 , L2 and L3 and proceeded using the curved curettes and the rongeurs to complete our laminectomies at L1, L2 and L3.
Thanks for anyone's imput.