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63030 vs 63047

  1. #1
    Red face 63030 vs 63047
    Medical Coding Books
    I have a discrepancy with codes. Would you code this case 63030-50, 63035, 69990 or would you code it 63047, 63030-51, 69990 (although I don't think you can code 63047 and 63030 together)
    Thanks for any assistance!

    Here is the case:

    The patient has dx of 722.10 and 724.02.

    Procedure performed:
    1. Left L1-2 microlumbar discectomy with use of the operating microscope.
    2. Bilateral L2-3 decompressive hemilaminotomies with use of the operating microscope.

    The operative report reads:

    Initially, decompressive hemilaminotomy was performed on the right. A very small portion medial aspect of facet was removed. The ligamentum flavum was removed piecemeal with Kerrison punch exposing the thecal sac and traversing the nerve root which were exposed above and below disc space and appeared well decompressed. A hemilaminotomy was then performed on the left at L2-3. Again, a small portion of medial aspect of facet was removed. The ligamentum flavum was removed piecemeal with Kerrison punch and exposed the traversing nerve root and thecal sac above and below disc space. They appeared well decompressed.

    A hemilaminotomy was then performed at L1-2 on the left. A small portion of the medial aspect of facet was removed. The ligamentum flavum was removed piecemeal with Kerrison punch exposing the thecal sac and traversing nerve root. I removed a further portion of the L2 lamina on the left and exposed nerve root as it passed medial to the pedicle. I then gently retracted the thecal sac medially and encountered extruded disc fragment which was extracted in multiple fragments using a microrongeur and angled microdissector. When I completed decompression, I was able to pass large ball-tip nerve hook beneath the thecal sac and beneath the nerve root medial to the left L2 pedicle.

  2. #2
    Location
    Salt Lake City
    Posts
    77
    Default 63030
    I personally would use the 63030-50 and the 63035. 63047 doesn't say anything about the hemilaminotomy, where the 63030 does specifiy a hemilaminotomy. Anyways, that's they way I read it.
    codermcdreamy CPC, CPC-H

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