# Dural Repair



## nyyankees (Oct 19, 2009)

Is a dural repair separately billable when performed with a spinal fusion, lumbar decomprssion? The dural repair was done during the decompression. Thanks.


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## kjpollock (Oct 20, 2009)

*Dural repair*

Typically no because the dura should not be opened during a lumbar decompression.  If the dura is opened it's usually because of a complication (eg, incidental durotomy or dural tear).  Therefore, repair of something you inadvertently did during the procedure is not separately billable.  

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com


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## RebeccaWoodward* (Oct 20, 2009)

Great to see you here Kim!!

If a dural (cerebrospinal fluid) leak occurs during a spinal procedure, repair of the dural leak is integral to the spinal procedure. CPT code 63707 or 63709 (repair of dural/cerebrospinal fluid leak) should not be reported separately for the repair.


http://www.cms.hhs.gov/NationalCorrectCodInitEd/01_overview.asp#TopOfPage

Chapter 8


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## kjpollock (Oct 20, 2009)

Thanks Rebecca! I will try to help as I can.

Kim


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## nyyankees (Oct 20, 2009)

Thanks!!


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## Prada (Feb 8, 2021)

nyyankees said:


> Is a dural repair separately billable when performed with a spinal fusion, lumbar decomprssion? The dural repair was done during the decompression. Thanks.





kjpollock said:


> *Dural repair*
> 
> Typically no because the dura should not be opened during a lumbar decompression.  If the dura is opened it's usually because of a complication (eg, incidental durotomy or dural tear).  Therefore, repair of something you inadvertently did during the procedure is not separately billable.
> 
> ...


 I had a question in this regard.

* I understand that dural repair is not separately billable because it is incidental to the Surgery. Can we bill modifier 22 because of the durotomies?*

Doctor did an ACDF (Anterior Cervical Discectomy and Fusion) and noted the following complication.


Durotomy X2; given the adherence of the disc to the dura the patient during decompression suffered two durotomies.


* Can we add modifier 22  to  22551 and 22552? And should we add a diagnosis code for the complication?*


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