The new knee surgery and laminoplasty codes will pay more than $1,000 each, before being adjusted for
geographic location. Laminoplasty Pay Exceeds Some Expectations The new laminoplasty codes, which CPT introduced effective Jan. 1, 2005, follow:
63050 - Laminoplasty, cervical, with decompression of the spinal cord, two or more vertebral segments
63051 - Laminoplasty, cervical, with decompression of the spinal cord, two or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [e.g., wire, suture, mini-plates], when performed). Medicare assigned 37.23 nonfacility RVUs to 63050, totaling payment of about $1,410, and assigned 42.36
nonfacility RVUs to 63051, giving it a base rate of about $1,605.
According to the AMA's CPT Changes 2005: An Insider's View, these new codes "involve procedures which leave portions of the posterior elements intact," unlike the existing posterior decompression codes 63015 (Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or diskectomy [e.g., spinal stenosis], more than two vertebral segments; cervical) and 63001 (Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or diskectomy [e.g., spinal stenosis], one or two vertebral segments; cervical), which involve complete removal of the posterior spinal elements.
Good news: The new RVUs demonstrate the complexity that goes into the "open-door" laminoplasty that the new codes describe. "Code 63015 only pays about $1,357, and 63001 pays about $1,098, so Medicare clearly understood the additional difficulty that goes into the open-door laminoplasty," says Heather Corcoran, coding manager at CGH Billing Services in Louisville, Ky.
Knee Procedures Score High RVUs Medicare plans to pay about $1,050 for the new mosaicplasty code 29866 (Arthroscopy, knee, surgical; osteochondral autograft[s] [e.g., mosaicplasty] [includes harvesting of the autograft]), and about $1,249 for the corresponding mosaicplasty with allograft code 29867 (Arthroscopy, knee, surgical; osteochondral allograft [e.g., mosaicplasty]).
In addition, Medicare assigned a healthy 44.71 non-facility total RVUs to the new meniscal transplantation code 29868 (Arthroscopy, knee, surgical; meniscal transplantation [includes arthrotomy for meniscal insertion], medial or lateral), which will bring about $1,694 for this procedure.
Caution: "Remember that 29868 already includes the $600 to $650 base pay that you'd get for the meniscectomy itself if you perform it in the same compartment as the transplant," Corcoran says, "so don't bill the meniscectomy (29881-29882) separately." Wound VAC Code Payment Doesn't Materialize Many orthopedic coders were thrilled to hear that the AMA created two new [...]