Wiki Spinal Coding - Any suggestions would be greatly appreciated

[Colleen25]

Any suggestions would be greatly appreciated. Our physician is coding CPT 63045 (Laminectomy, facetectomy and foraminotomy) with CPT code 63287 (Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical) which are bundled? Is it appropriate to un-bundle with modifier 59, or no because they were performed at the same levels C6-C7? Thanks!

Codes he's billing

Laminectomy for decompression C1-C7
63045-C1
63048-C2
63048-C3
63048-C4
63048-C5
63048-C6
63048-C7
63048-C8
Intradural exploration for itramedullary tumor C6-C7

 

[RebeccaWoodward*]

Any suggestions would be greatly appreciated. Our physician is coding CPT 63045 (Laminectomy, facetectomy and foraminotomy) with CPT code 63287 (Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical) which are bundled? Is it appropriate to un-bundle with modifier 59, or no because they were performed at the same levels C6-C7? Thanks!

Codes he's billing

Laminectomy for decompression C1-C7
63045-C1
63048-C2
63048-C3
63048-C4
63048-C5
63048-C6
63048-C7
63048-C8
Intradural exploration for itramedullary tumor C6-C7

You've posted 63287 (thoracolumbar) in your question but I believe you meant 63285 (cervical) since your levels are for the cervical region. In my opinion, 63045 would be included in 63285 since 63285 is per region. It appears your better off reporting 63045 + 63048 x 6 (assuming there is supportive documentation). The work RVU's for 63045/63048=38.77 (total) whereas 63285 has work RVU's of 38.05. Also, I noticed you have 63048 for C-8 but your previous reference indicates C1-C7. The cervical spine only contains 7 vertebrae. Not sure what you're referencing for C-8.

Does anyone else have any thoughts?

 

[Colleen25]

Thanks Rebecca, you are correct it was 63285 and C1-C7 (I was obviously in a hurry) Thanks again for your help!!

Colleen