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?? Decompression included in Total Disc Replacement

  1. #1
    Default ?? Decompression included in Total Disc Replacement
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    The physician documented that the nerve roots were completely decompressed while performing a total disc replacement device in the lumbar region. Please advise if this documentation would support billing CPT 64999 for the decompression, along with CPT 22857 for the total disc replacement.

    The window was made with a 15 blade followed by use of pituitary rongeurs, Kerrison rongeurs, curettes, and end-plate dissecting tools to completely remove the end-plate cartilage as well as the disks. Once down to the level of the posterior longitudinal ligament, the disk was completely removed and the posterior longitudinal ligament was gently released to make sure that there was no disk material behind the ligament. Once this was completed and the nerve roots were completely decompressed and the annulus was released posteriorly, the space was examined and was found to be well mobilized.

    Any thoughts on this would be welcome...

  2. Default
    Even though he completely decompressed the nerve roots, this is included. In the Neurosurgery coding companion, states as follows: "Peparation may include discectomy, osteophytectomy for nerve root or spinal cord decompression"... I would just bill the artifical disc code.

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