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microlaminotomies with interspinous fusion instrumentation, with PLF, codes?

Maurice Posted Fri 28th of December, 2012 23:58:43 PM

How to code for two levels where I did microlaminotomies, and PLF fusion with interspinous instrumentation?

SuperCoder Answered Fri 04th of January, 2013 22:06:47 PM

Hi,

We are working on this. Will get back soon with the answer.

Thanks

SuperCoder Answered Fri 04th of January, 2013 22:06:47 PM

Hi,

We are working on this. Will get back soon with the answer.

Thanks

SuperCoder Answered Tue 08th of January, 2013 16:03:59 PM

When coding for laminotomy (or microlaminotomy) and spinal fusions, focus on interspaces to determine the correct number of codes. Count one interspace as one code, instead of reporting multiple codes for adjacent spinal levels. Also please note that the codes below are based on the assumption that the laminotomy surgery is the initial procedure, not re-exploration.

For microlaminotomy, report either 63020 (for cervical level) or 63030 (for lumbar level). Because your surgeon used a less invasive approach, check whether the payer requires you to append modifier 52 for reduced services.

PLF is also known as posterolateral fusion. Report it with 22612, unless the surgeon's documentation notes a particular reason for the fusion (such as spinal deformity, which you might report as 22800). Again, you'll submit only one code because you base your selections on the number of interspaces.

Posterior instrumentation should be coded as 22840 (for nonsegmental) or 22841. Some payers (particularly Medicare) bundle 22841 into the primary procedure and won't pay separately for both codes.

As with all cases involving multiple procedures, check with your payer about whether certain codes are bundled or if you need to append modifiers.

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