Ligament reconstruction of posterior interspinous ligament CPT code?

ahalle

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So needing some help here, I have not seen this ligament repair before and can't find a code to fit it. I would appreciate some additional input and point of views.

Diagnosis: Lumbar disk herniation with stenosis.

Procedure:
1) L2-L3 bilateral hemilaminotomies with left-sided microdiscectomy.
2) Ligament reconstruction of posterior interspinous ligament


... At this point, brought an operative microscope performed a bilateral hemilaminotomies inferior aspect of L2, superior aspect of L3, and took down intervening ligamentum flavum. There are partial medial facetectomies on the left side. We were able to gently retract the thecal sac. There was noted to be extruded disk herniation migrate up cephalad to the disk space. We removed this fragment, we do not actually get into the disk space. We could not really palpate the annular tear. We tried irrigated as well. The disk space was flap. At this point, we thought this level was somewhat hyper mobile, which elected to reconstruct the ligaments to decrease the stress on this disk and hopefully try to prevent some of this further wherein disk herniation potential fusion in the future. At this point, we used penetrating towel clamp and made holes across the lamina, spinal lumbar juntion both L2 and then L3, passed Mersilene tape through this tied it down to support these vertebral segments together. We copiously irrigated, injected local anesthetic, closed the fasia over drain, closed subcutanious tissue over another drain, closed the skin with Monocryl as well as Mastisol and Steri-Strips.
 

talton0206

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I would query my surgeon for additional information. Have him/her describe how the ligament was reconstructed. I suspect this will be an integral part of the primary procedure but without a more detailed description it's unclear.

Tammy Alton
 
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