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neuro sx

  1. Default neuro sx
    Medical Coding Books
    I didn't see a forum for neuro sx so asking on here. I have a pt who had a laminectomy bilateral on levels L2-3, L3-4, and L4-5. Medicare denied for units. Codes used were 63042 and 63044 can someone please help with how to bill out all the levels and bilaterally?

    TIA

    Tracey

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by cooper1 View Post
    I didn't see a forum for neuro sx so asking on here. I have a pt who had a laminectomy bilateral on levels L2-3, L3-4, and L4-5. Medicare denied for units. Codes used were 63042 and 63044 can someone please help with how to bill out all the levels and bilaterally?

    TIA

    Tracey
    63042-50 L2-L3 (1 unit)
    63044-50 L3-L4 (1 unit)
    63044-50 L4-L5 (1 unit)

    Is this how you billed it?

  3. Default
    No the coder for that coded it as 63042-50 with 2 units and 63044-50 with 4 units as our system doesn't increase the fee and doesn't allow the L2-3 in our system.

    So I guess we need to have our employees who post to increase the fee when entering the charges but what do we do about not having L2-3 ect in our system?

  4. #4
    Location
    North Carolina
    Posts
    3,126
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    What do you mean..."doesn't allow the L2-3 in our system"?

    When posting bilateral procedures, we manually double the fee for each procedure.

  5. Default
    Do u add L3-4 and L4-5 onto your claim?

  6. #6
    Location
    North Carolina
    Posts
    3,126
    Default
    Ohhh...I think I see what you're saying. No. I don't add the actual levels (L1-L2) to the claim. I was only showing you what CPT code went with each level. You'll just enter...


    63042-50
    63044-50
    63044-50

    One thing I want to mention...Some of my carriers deny the 3rd level as a duplicate. For those carriers that I know are a problem for this, I add 59 also. So...You may have some that request:

    63042-50
    63044-50
    63044-50/59

    It should be self explanatory that the 3rd level is an additional level but, for whatever reason, they need things simplified for them.

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