Wiki Orthopedic spine coding

Create Wiki
D

dtamayo

Contributor
Messages
14
Best answers
0
I am new to coding for orthopedic spine surgeon and I am not quite understanding the difference between codes 63047 and 63030, the payer is BCBS and they have denied 63030 for inclusive, can anyone help?
 
the way it was explained to me by my spinal orthopod and the coder that trained me is that 63030 is focused on taking a small portion of the lamina to get to the interspace or disc the entire lamina is not removed and 63047 is removing the entire lamina (whether it be for the entire segment or just the inferior part or superior part) to treat the spinal canal.

63030
-right or left
-bilateral billed as x2
-treat disc space (ive often seen for herniation)
-small portion of lamina removed

63047
-bilateral procedure
-treat the canal
-entire lamina removed (right to left)
-if part of disc is removed as well it is included in this as it is more extensive

Hope this is helpful!
 
dtamayo said:
I am new to coding for orthopedic spine surgeon and I am not quite understanding the difference between codes 63047 and 63030, the payer is BCBS and they have denied 63030 for inclusive, can anyone help?
Click to expand...

The second response of this previous thread has a good explanation of 63030 vs 63047:

https://www.aapc.com/memberarea/forums/20293-63030-vs-63047-a.html

Also, googling "63030 vs 63047" will bring up several other helpful articles.

Are you using 63047 and 63030 for the same level? If yes, there are NCCI edits in place that bundle 63030 into 63047. If they are for different levels performed on the same day, you'll have to use the appropriate modifier.

Post the scrubbed op note and all codes billed for that day for more help.

HTH!
 
ok so what if decompression was done ? is that also included in 63047 or is there a different code for decompression.
 
You must log in or register to reply here.
Top