Results 1 to 2 of 2

Revision Laminectomy ..What do you think?

  1. Default Revision Laminectomy ..What do you think?
    Medical Coding Books
    Hello everyone. One of our physicians crossed off the redo laminectomy codes and put 63047 and 63048-22 modifier due to a revision. This confused me. I thought it would be a redo and he is very familiar with the redo codes.

    May I have your opinions please on the laminectomy portion?

    Procedure: Revision L2-L5 laminectomy and foraminotomy on the left side
    Posterior spinal fusion, L2-L5
    Revision, left foramintomies L2-L5

    Incision was made along the old incision and the spinous process of L1 and L2 were exposed down the L5. The left hand side lamina was exposed from L2 down to L5. Great care was taken to make sure that there was no dural rent. First the lamina at L2 and then lamina at L5 were completely taken down to the facet. Next, dissection was carried out laterally. The facets of L2-3, L3-4, and L4-5 were identified. Next, a rougeur was used to take off the soft tissue more medial to this. A trocar was used to scrape the medial aspect of the old laminectomy site. There was a very small laminectomy that had been performed, that was done almost all away to midline. At this time, a bur was used to thin the lamina from L2 down to L5 and a curved curette was used to elevate some of the bone. Next, a Kerrison was carefully used to remove the lamina from L2, L3, and L4 down to L5. A portion of L5 was also taken down. Nest the facet joints were very hypertrophied as well since there was significant amount of foraminal stenosis. I did decide to burr out the facets. There was significant stenosis at that level in teh foramen and teh foraminotmies from L2 down to L5 were performed and great care was taken into the dura.

  2. #2
    North Carolina
    CPT code 63040 and 63042 are the only codes which may be reported for procedures performed on a recurrent herniated nucleus pulposus. (per AMA) 63047 is used to report procedures performed for lateral recess stenosis, for example, caused by either ligamentum flavum hypertrophy or facet arthropathy. Since he mentioned significant stenosis, this may be why he opted for this code. Also, CPT has stated that 63047 can be used for a revision surgery (stenosis)

Similar Threads

  1. Revision Laminectomy
    By kellit21 in forum Orthopaedics
    Replies: 1
    Last Post: 04-01-2015, 09:06 AM
  2. Laminectomy L4 & L5 & Partial Laminectomy L3
    By Joyce Burchett in forum Neurology/Neurosurgery
    Replies: 0
    Last Post: 01-29-2015, 01:53 PM
  3. revision laminectomy?
    By in forum Orthopaedics
    Replies: 0
    Last Post: 08-27-2013, 02:35 PM
  4. Revision laminectomy
    By mmce in forum Orthopaedics
    Replies: 0
    Last Post: 05-31-2013, 05:38 AM
  5. Laminectomy & Partial Laminectomy
    By TammyVan in forum Orthopaedics
    Replies: 0
    Last Post: 01-20-2011, 11:58 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.