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Staged Procedure for Laminoplasty

Renita Posted Tue 03rd of April, 2012 20:46:08 PM

How would I code this staged procedure? Stage 1...Anterior cervical diskectomy, C7-T1 with arthrodesis, peek insertion also morcellized autograft. Stage 2.....Inferior laminotomy on C2, Superior laminotomy on T1. Left sided osteotomy on C3-C7 and right sided osteotomy on C3-C7. Cervical laminoplasty on C2-C7. Rib structural l arthrodesis on C3-C7. Posterior and posterolateral arthrodesis on C2-3, C3-4. C2-3 and C7-T1 segmental instrumentation. Any help would be so appreciated!!

SuperCoder Answered Wed 04th of April, 2012 07:45:08 AM

Anterior cervical diskectomy, C7-T1 with arthrodesis --> 22554 (when no decompression)
PEEK insertion also morcellized autograft --> +22851
Morcellized autograft --> +20937
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Stage 2:

Inferior laminotomy on C2 --> do not bill 63001 separately, it is included within "Cervical laminoplasty on C2" - code 63050
Superior laminotomy on T1 --> 63003
Left sided osteotomy on C3-C7 --> 22210
Right sided osteotomy on C3-C7 --> No separate payment made for both sides, so no use of appending mod. 50/LT-RT.
Cervical laminoplasty on C2-C7 --> 63050
Rib structural l arthrodesis on C3-C7 --> 22554, +22585, +22585, +22585 (not sure about this one)
Posterior and posterolateral arthrodesis on C2-3, C3-4, C2-3 --> 22600-59, +22614-59, 51, +22614-59, 51
C7-T1 segmental instrumentation --> +22842

SuperCoder Answered Wed 04th of April, 2012 07:46:01 AM

Append modifier 58 with all stage 2 CPT codes.

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