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Laminectomy Coding Help

  1. Default Laminectomy Coding Help
    Medical Coding Books
    Hello....I am trying to code a laminectomy of C5, C6 and C7 also T1 and T2. The physican coded 63045, 63046, 63048 x3. I am getting an error stating that 63046 is bundled with 63045 which I cannot comprehend since they are seperate regions.

    "Midline incision made in posterior aspect of neck with dissection being carried down to expose the spinous processes of C4 - C-5, C6 - C7, T1 and T2. Pilot holes were drilled into the lateral masses of C4, C5, C6, and C7 bilaterally. These were tapped and palpated and noted to be satisfactory. Following this a drill out laminectomy was carried out with removal of the lamina of C5, C6 and C7 as well as T1 bilaterally using a channel drilled up either side and then completing the disconnection using 1mm Kerrison punch. The lamina were removed on block exposing the dura. Following this the superior aspect of the T2 lamina was then drilled out with a high speed drill and removed with Kerrison punches...."

    Since were are dealing with the C-spine and T-spine is it compliant to bill 63045, 63046,59 and 63048 x3?

    Your help will be greatly appreciated....Thank you

  2. Default
    I would not use the 63046, since all the segments are together. I would use the 63045 and the subsequent levels would be 63048 (since that covers cervical, thoracic and lumbar).

    I think the thoracic should be coded as an additional level.

  3. #3
    North Carolina
    I agree. Since the regions "cross over", I would have one primary code with the correct subsequent add on code to report the additional segments/levels.
    Rebecca CPC, CPMA, CEMC

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  4. Default
    Thank you ladies, that was my initial thought but I kept re-thinking it. Have a great day!

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