# Decompressive laminectomy with removal of synovial cyst



## Melody Morland CPC

The surgeon and I are at a difference of opinions for the coding of the following procedures:
1) Bilateral decompressive laminectomy L5-S1 with total facetectomy L5-S1 (left)
2) Removal of Foraminal Synovial Cyst

We are debating 63267 for a combined procedure, the doctor feels there should be additional coding for the removal of the synovial cyst, I don't see another code is appropriate.  Are we both off? Are their other codes that better describe the service?
Any help is appreciated!
Thanks


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## todd5400

This is the appropriate code.  If he used microdissection during the procedure also code 69990.


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## Melody Morland CPC

Thanks so much for your help!


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## deb.witt@uhsinc.com

*Laminectomy with microsurgical excision of synovial cyst*

Our surgeon performed a L4-5 laminectomy, foraminotomies, neurolysis of nerve roots plus nmicrosurgical excision of bilateral synovial cyst.  We billed as follows:

63047
63048
63267
69990

The CPT 63267 is being denied for content of service to the 63047 and 63048. Did we bill this incorrectly?


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## RebeccaWoodward*

dwitt@srhc.com said:


> Our surgeon performed a L4-5 laminectomy, foraminotomies, neurolysis of nerve roots plus nmicrosurgical excision of bilateral synovial cyst.  We billed as follows:
> 
> 63047
> 63048
> 63267
> 69990
> 
> The CPT 63267 is being denied for content of service to the 63047 and 63048. Did we bill this incorrectly?



These do bundle per NCCI edits.  There would need to be a separate level/separate incision involved for this to be billable.


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