Wiki Synovial Cyst Resection w/ Laminotomies

[Paigelyn]

Need some help with coding laminotomies with cyst removal. Below is the relevant information from the note. I have seen 63267 suggested for removal of the synovial cyst, but the surgeon did not do a laminectomy at that level. He did a laminotomy.
--Bilateral re-do laminotomies and foraminotomies completed at L1, L2 and L3 for decompression of nerve roots. There was severe critical stenosis so the the left L1 and L2 pedicles were drilled down for transpedicular decompression. He encountered a left L2-L3 synovial cyst and facet cyst, which was resected with microdissection under the microscope. --

Thoughts?

 

[amandamkcj]

Here is information from Zupko/AANS seminar book " Excision of a snyovial cyst may be reported with a non-neoplasm code or with a laminectomy code depending on the incremental work involved. If fairly straightforward, use a code such as 63047. If far more involved (eg, adherent to the dura), then may use a code such as 63267. Don't forget--63267 includes any number of levels of laminectomies".

Based upon the little snippet of the report provided there isn't any documentation supporting far more work (unless that portion of the report isn't posted) so based upon what is posted I would capture 63047.