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Reporting lumbar decompression versus interlaminar stabilization device (Coflex)

Gina Posted Mon 12th of November, 2018 19:26:28 PM
Cpt codes 22867/22868 (insertion of interlaminar device) description includes decompression and these codes are bundled with the decompression codes 63047/63048. If both procedures are performed, the decompression code is considered the most extensive procedure, would that be reported? Or would the 22867 be reported and should be based on the intent of the surgeon when documented in the indication? Indication documents that patient was taken to OR for lumbar decompression with possible insertion of the coflex device. Listed procedure: 1) Lumbar laminotomy/foraminotomy/decompression 2) Insertion of Coflex device
SuperCoder Answered Tue 13th of November, 2018 03:19:51 AM

Hi Gina,

Thank you for your question.

 

As per AMA guidelines, CPT® codes 22867/22868 should not be reported with 63047/63048 for the same level.

Also, Correct Coding Initiative edits do not allow you to code the stabilization device codes alongside the laminectomy code. Hence, report CPT® code 63047/63048 for Lumbar laminotomy/ foraminotomy/ decompression.

 

Note: Modifier-59 (Distinct Procedural Service) can be appended to CPT® code 22867 only when insertion of interlaminar stabilization/distraction device and laminectomy are performed at different spinal levels.

 

Please feel free to write if you have any question.

 

Thanks

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