Charles Posted Thu 25th of October, 2012 19:31:07 PM
How to code the folliwing:
1. Decompressive Laminectomies Total L3, partial L2-L4
2. Bilateral Forminotomy L2-3 & Redo L3-4
3. Only Dural Graft with PAM
My concern: if coded as 63042 and 63043 for the add on-how do I capture the bilateral foraminotomy? Use modifier? Want to make sure the surgeon gets credit for the Redo...
SuperCoder Answered Mon 29th of October, 2012 17:14:27 PM
Forego 63047 (Laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s) (e.g., spinal or lateral recess stenosis)], single vertebral segment; lumbar) in favor of 63042 (Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, re-exploration, single interspace; lumbar), even if the redo laminotomy/hemilaminectomy extends to create a laminectomy (removal of entire laminar segment).
The code descriptor for 63042 specifically states "re-exploration," and therefore includes typical additional work required for operating in an altered surgical field, which may include dissection of scar tissue and adhesions.