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Duroplasty and Laminectomy

Adrienne Posted Mon 30th of September, 2013 15:24:14 PM

A pt came to the ER with a CSF leak from a previous laminectomy. My doc had to take the patient to the OR to repair the CSF leak(63709)and laminectomy (63047). I know that 63047 and 63709 bundles but since my doctor did not cause the CSF leak can we still bill for 63709 with a modifer?

SuperCoder Answered Tue 01st of October, 2013 00:06:09 AM

Bundling issues: If the dural injury occurs during the operative laminectomy, CCI bundles the dural repair with the laminectomy procedure. For example, if you read in the operative note that the surgeon performed a lumbar laminectomy, facetectomy and foraminotomy, and during this procedure there was a dural tear that created a fluid leak and the surgeon subsequently repaired the dural injury with Nurolon, you only report 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). You do not report 63709 as CCI bundles 63709 into 63047.

"You would not report 63709 and 63047 together. If your surgeon does the procedure for a decompression and laminectomy and also repairs the dura, you would only bill the CPT® 63047 for the spine procedure,"

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