Wiki Please HELP Break the Tie!

[CynthiaT]

I have 2 separate questions that I am hoping to get another opinion on, please.

1) Physician performs right-sided L5-S1 hemilaminotomy and foraminotomy: would this be coded as a 63030 or, 63030-52 (because of no mention of facetectomy)?

2) How do you code laminectomies (laminectomy,facetectomy & foraminotomy) by vertebral segment: code L2-L3 as 63047 or code it as a 63047 and 63048?

I sincerely appreciate your help with all of my questions. I am being told more than one way and, since I am new to this, I don't want to get into a bad habit.

Thank you-

 

[RebeccaWoodward*]

Question 1 -63030
The description states: Hemilaminectomy w/ decompression of nerve roots(s), including partial facetectomy, foraminotomy and/or excision of herniated disc. Whereas, 63047 states facetectomy AND foraminotomy.

Question 2- That really depends on the documentation. If both roots are seen (L5 AND S1), it is possible to code 63047 and 63048. Again, the documentation MUST support this.

"For example, if just the L5 roots are seen with an L4/L5 lami, code 63047 “Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (eg, spinal or lateral recess stenosis)), single vertebral segment; lumbar” would be reported. If both the L4 and L5 root pairs are seen in this procedure, codes 63047 and 63048 would be used. The documentation must support the root levels being decompressed."

http://www2.aaos.org/aaos/archives/bulletin/aug04/code.htm

 

[CynthiaT]

Clarification needed, please

Rebecca,
In my question #1...my 2 choices were 63030 or 63030-52. Which would you code it with? I was thinking 63030-52 since, it only describes the physician performing right-sided L5-S1 hemilaminotomy and foraminotomy. (and, not the facetectomy) Would you agree?

Thanks for the help!

 

[RebeccaWoodward*]

On my previous post, I selected 63030 for the answer to "question 1". I was only comparing the verbiage between 63030 and 63047. I selected 63030 since this is, inherently, a unilateral procedure....Since the procedure was performed on the RT side, you would report 63030...modifier 52 is not required. If the physician had performed 63030 bilaterally, RT and LT, you would report 63030-50