Wiki Type 1 Osteotomy/Type 1 Schwab Osteotomy

[SHOES29]

I have a surgeon that performed a L4-L5 type 1 osteotomy. It looks like it's a total facetectomy. Has anyone coded a type 1 osteotomy? I have also seen it called a type 1 Schwab Osteotomy. Not sure of what CPT code to use.

Thanks!

 

[MsAnna]

I do code osteotomies but I've not heard Type I or the Schwab Type I. Any other bone removed other than the facets? Also, I'm wondering what the diagnosis is for this that you are using.

 

[SHOES29]

No bone is removed. Complete removal of the facets without laminetcomy. Sometimes he will do a SPO at say level L1-L2, L2-L3 and then type 1 osteotomy at levels L4-L5. Diagnoses is for either flat back or kyphosis.

 

[MsAnna]

I actually just meet with one of my provider to discuss the osteotomy codes and work involved. Again, I've not heard of a Type 1 osteotomies but being that he only removed the facets(complete), Itmakes me think of a Gill Procedure. Does he document removal of the ligaments? I can email you the diagram I have but it shows the posterior column as removal of the sponous process, bilateral facet joints, ligaments and bilateral lamina's. We would also use flat back sydnrome or kyphosis as for the posterior column osteotomy. You might need to use an unlsited code or perhaps append modifier 52 for reduced service. If you are comfortable with your osteotomy knowledge, or even if your not, I would query the provider and ask what a Type I is.