# Hemilaminectomy Help with Neurosurgery



## Vanessa123 (Feb 1, 2010)

Hello everyone,

I am in need of some help with coding some neurosurgies. I am very new to this speciality and I am uncertain on what should be coded.

The Dr. has sent over CPT codes 63047, 63048. and 63030. I am not sure that these are correct.

Here is the OP report:

Operative procedure:
1) Left-sided L3 hemilaminectomy
2)L3-4 diskectomy
3)L2-3 foraminotomy
4)L3-4 foraminotomy
5)Intraoperative fluroscopy

Postoperative diagnosis: Herniated disks at L2-L3 and L3-4 with L3 and L4 radiculopathies

Technical Description:

After successful induction of anesthesia and intubation, a Foley cather was placed. The patient was prepped and draped in a sterile fashion 
 and a 4 cm incision was marked and infused copiously with Marcaine with epinephrine. Incision was made with a #10 scalpel blade and the soft tissues were dissected with electrocautery down to the lumbodorsal fascia. The lumbodorsal fascia was identified and incesed with a #11 blade and subperiosteal dissection was begun using electrocautery and Cobb elevators. A left-sided L3 hemilaminectomy was performed using a high-speed drill, Kerrison punches, and curettes. A Woodson elevator and nerve hooks were used to deliver disk fragments which were then removed with pituitary rongeurs. The  hole in the posterior longitudinal ligamnet at L3-4 was discovered using a nerve hook and the disk space was inpected micropituitary rongeur; all free disk fragments were taken from the disk space. Medial facetectomy at L2-3 and L3-4 with generous foraminotomies were then made, such that Woodson elevator could be attached into the foramen comfortably. Hemostatasis was achieved and the would was copiously irrigated with antibotic impregnated saline.

I think that is would just be 63030, 63035.

He is also wanting to code for the fluoroscopy 77001. Isn't that included in the procedure or not?

Any help is greatly appreciated.

Thanks.

Vanessa


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