Charles Posted Tue 02nd of October, 2012 20:22:31 PM
I need help coding the following Surgical Precert: ***No op report***
1. Cervical Laminotomy C6-T1 with resection of spinal cord tumor/mass
(Surgeon will be putting the bone back in with plate and screws)
Thinking the following:
Laminotomy - 63020 for C6, and 63035 for C7-T1
Screws and Plate - 22845
How to capture the resection of the spinal cord mass?
The mass extends from C6-T1
I'm thinking C6-7 63275 and C7-T1 63276? both listed with modifier 59?
Charles Posted Tue 02nd of October, 2012 20:28:49 PM
The screws and plates shouldn't be 22845, it should be 22840. Posterior approach.
SuperCoder Answered Wed 03rd of October, 2012 18:47:38 PM
The answer depends on the type of mass the doctor operated on. If the mass was a neoplasm, you should report 63275 (Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical).
If it was not a neoplasm, look at code 63265 (Laminectomy for excision of intraspinal lesion other than neoplasm, extradural; cervical). For example, this is the code you would report for excision of a synovial cyst. You should submit the diagnosis and the procedure codes via a pathology report, in case of audit.
Rest codes are correct.
Charles Posted Wed 03rd of October, 2012 19:09:50 PM