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Cari Posted Tue 28th of February, 2012 10:43:09 AM

When billing a corpectomy the decompression is inclusive in the coding. What if the decompression is done as a separate part of the procedure. Example: Patient has a Posterior fusion, decompressive laminectomy and foraminotomy, with instrumentation. Then the patient is flipped and has an anterior approach cervical corpectomy with fusion. All at same session and all done at same levels within the cervical spine.

SuperCoder Answered Wed 29th of February, 2012 08:04:09 AM

The CPT codes, as per descending order of RVU values are:

Anterior approach cervical corpectomy -- 63081
Posterior fusion -- 22600 (if below C2)... else 22590 / 22595
(Posterior) Decompressive laminectomy and foraminotomy, cervical, single level -- 63020
Posterior Instrumentation -- +22840 / +22841 / +22842 / +22851 (based on type of instrumentation documented)

Anterior fusion is the concern now. Since posterior fusion is already done, it might be difficult to get a payment for ant. fusion at same level. You could try with 22554, though.

Cari Posted Wed 29th of February, 2012 12:47:23 PM

The concern was the decompression. Because the corpectomy specifically states that the decompression is inclusive in the code. So you are stating that the decompressive laminectomy would be proper to bill separately in this case? Is it because it is part of the posterior portion of the procedure?

SuperCoder Answered Thu 01st of March, 2012 06:03:48 AM

Yes, you could bill separately. since "approach" is the biggest factor in deciding code(s) for laminectomy Px..... Decomp. Lami. was done via posterior approach... and corpectomy done via anterior approach.

Also, one of my learned colleague and coding expert, Kristi, confirmed that you can definitely bill 22554 for that anterior fusion.

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