Page 1 of 2 12 LastLast
Results 1 to 10 of 14

Segment vs Interspace

  1. Default Segment vs Interspace
    Exam Training Packages
    Would a Laminectomy on L4 - L5 be considered 1 segment, or 1 interspace? Thanks for any help.

  2. Default
    For a laminectomy, you would count per interspace as they are removing the lamina in between each segment. In this case, L4-L5 would count as one interspace.

    And (yes Frosty) the CPT code description tells us whether we count segments or interspaces. For example 63045-63047, states "segment" therefore L4-L5 would be two segments = 63047, 63048.
    Last edited by lorebe22; 01-27-2012 at 09:39 AM.

  3. #3
    Default
    I've recently started coding for a spine surgeon and am confused about this. If he does a laminectomy at L4 and L5 for spinal stenosis & the code is 63047, it states "single vertebral segment" and the add-on code 63048 states "each additional segment", so why can't we bill both codes. I don't think laminectomy is talking about the interspace in this case, is it? I understand that if he's doing a laminotomy at L4-5 for, say, herniated disc, then we would have to use 63030, as it states interspace. Help!

  4. #4
    Default
    Something to keep in mind;

    L4 - L5: - (dash) = interspace
    L4, L5: , (comma) = segment/level

  5. #5
    Default 63047,63048
    CPT descriptor states per segment not interspace, I interpret this as L4,L5, etc. Meaning if Laminectomy for stenosis was performed L4-L5 this would be two segments 63047,63048. However, I have been having a hard time getting these paid.
    Seems to be disputable across the board. Would be great to get a definite correct answer...if anybody else would like to contribute. ty

  6. #6
    Default
    I have been billing the 63047 & 63048 per segment as the code states. I'd like a definitive answer, too, but according to the code, it's per segment.

    Also, Lorsho seems to have contradicted him/herself when stating, "For a laminectomy, you would count per interspace as they are removing the lamina in between each segment. In this case, L4-L5 would count as one interspace.

    And (yes Frosty) the CPT code description tells us whether we count segments or interspaces. For example 63045-63047, states "segment" therefore L4-L5 would be two segments = 63047, 63048."

    First you stated "per interspace", then "segment". Just wanted to clear that up - unless I completely misunderstood you. Thanks everyone for your input.

  7. Default
    I have always been told at different coding seminars to bill per nerve root decompressed, per forminotomy. So if this is documented bill per segment, not documented per interspace.

  8. #8
    Default
    Thanks! That makes sense.

  9. #9
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by penguins11 View Post
    I have always been told at different coding seminars to bill per nerve root decompressed, per forminotomy. So if this is documented bill per segment, not documented per interspace.
    I agree. I was taught the same...

    For example, if just the L5 roots are seen with an L4/L5 lami, code 63047 “Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (eg, spinal or lateral recess stenosis)), single vertebral segment; lumbar” would be reported. If both the L4 and L5 root pairs are seen in this procedure, codes 63047 and 63048 would be used. The documentation must support the root levels being decompressed.

    http://www2.aaos.org/aaos/archives/b...aug04/code.htm

  10. #10
    Default
    I agree also-laminectomy is how you approach-for spinal stenosis they decompress nerve roots. Be sure your spine physician notes which nerve roots they decompress.

Page 1 of 2 12 LastLast

Similar Threads

  1. Segment 4 and 5 liver resection help please
    By lindacoder in forum General Surgery
    Replies: 1
    Last Post: 02-10-2015, 11:27 AM
  2. Anterior segment nuclear fragment
    By seslinger in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 04-01-2012, 02:46 AM
  3. Laminectomy - Segment vs. Interspace
    By broncsrox in forum Orthopaedics
    Replies: 4
    Last Post: 10-17-2011, 07:40 AM
  4. Distal intercoccygeal segment injection
    By jamharsh in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-16-2011, 11:35 AM
  5. Interspace (between the toes) injections
    By rryder1963 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 04-14-2008, 11:17 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?

Login

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.