need some clerification please hemilaminectomy and laminotomy

boyett

Networker
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my dr is doing the following:

LEFT L3 HEMILAMINECTOMY WITH FACETECTOMY FORAMINOTOMY
LEFT L4 LAMINOTOMY
RIGHT L4 HEMILAMINECTOMY WITH FACETECTOMY FORAMINOTOMY
RIGHT L5 LAMINOTOMY

from the cpt stating 63030 for laminotomy (hemilaminectomy) per interspace not segment I am treating it as if it reads L3-L4, L4-L5 being 2 levels

63030
63035

my dr is wanting to code for 3 levels using one of them as the 63047. I don't agree with that but would like some additional insight. my other question ...he is stating he wants to do this since it was different sides. is that relevant ?

any help is appreciated. thank you
 

StacyAnnSC

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I agree it is 2 levels L3-L4, L4-L5. Per a Zupko workshop I've attended. 63030 and 63047 are coded based on diagnosis as most doctors use hemilaminectomy, laminectomy, laminotomy interchangeably... if the procedure is for stenosis bill 63047, if it is for disc disease bill 63030.
 

sarab86

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Whats your DX at these levels?

Per CPT:
63030/63035 are unilateral in nature and are treated by interspace.
63047/63048 are bilateral in nature and are treated by segment.
*How 63047/63048 is used would be based on your Coding Compliance for your practice. My practice follows AANS, which explains that 63047/63048 are treated by "motion segment" i.e. L3-4 would be 1 motion segment.

If you DX is stenosis I would code that case as 63047/63048 for the motional segments at L3-4 and L4-5 and the scope if used.
 

boyett

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per the op note the dr states

L3-4 HERNIATED NUCLEUS PULPOSUS LEFT
L4-5 HERNIATED NUCLEUS PULPOSUS RIGHT

L3-4,L4-5 LUMBAR SPINAL STENOSIS SECONDARY DISK PROTRUSIONS.

THANK YOU BOTH FOR THE RESPONCES LOOK FORWARD TO HEARING FROM YOU SOON
 
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