# Anterior Cervical Foraminotomy/Diskectomy



## joanne71178 (May 7, 2013)

The insurance has denied this for incorrect coding.  The doctor is non-par with the insurance co.  I coded as 63075 as well as 69990 (since Dr. is non-par)  I'm stumped;  What would be the correct coding for this Anterior Cervical case?

Thanks in advance!  

POST OP DIAGNOSIS: Herniated nucleus pulposus left C5-C6-722.2

OPERATION PERFORMED: 
1. Left anterior cervical foraminotomy, left C5-C6
2. Left C5-C6 partial discectomy
3. Decompression of left C6 nerve root
4. Microscopic dissection


'The left anterior neck was prepped and draped in the sterile fashion.  An incision was made along Langer's lines and carried down to the platysma in a sharp fashion.  The platysma muscle was incised in the line with the incision and blunt dissection was then carried out between the trachea and esophagus medially and the sternocleidomastoid muscle and carotid sheath laterally.  The anterior cervical spine was identified.  An x-ray was obtained to confirm position at C5-C6.  The ongus colli muscle to the left of the midline was elevated out to the uncinate process of C5-C6.

Under microscopic guidance, the uncinate process was removed of C6 along with the lateral inferior aspect of C5, the lateral superior aspect of the C6 vertebral body.  This allowed entrance into the dural space and the left C5-C6 neural foramina.  A large herniated disk was identified with multiple fragments of the disk being removed without difficulty.  There was noted to be excellent compression of the dural sac and left C6 nerve root.  All bleeders were then cauterized.  The wound was irrigated with copious amounts of antibiotic solution.  The wound was closed in layers using Vicryl 2 in the platysma, followed by #4-0 interrupted Monopril in the subcutaneous tissue and Dermabond in the skin.


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## shenell333@yahoo.com (May 8, 2013)

Hi

I would code 63020 (I meant) and 69990

63075 is incorrect it includes osteophytectomy

Look at code 22551 thats a anterior approach includes microscope


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## joanne71178 (May 8, 2013)

I considered 63020, but that is a Posterior Approach. This procedure is Anterior approach.   

Any other thoughts or comments? I'm stumped..................


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## joanne71178 (May 10, 2013)

22551 has the correct approach, but there was not allo or auto graft performed.  Maybe I could use this code w/ a 52 modifier?  

Thanks!


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## joanne71178 (May 15, 2013)

Any other thoughts?  I'm still stumped.


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## shenell333@yahoo.com (May 15, 2013)

code 63075 Discectomy, anterior with decompression of spinal cord and/or nerve root (s)
micrscope is included


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## joanne71178 (May 16, 2013)

I agree, That is what I originally coded, but the insurance co. is saying it is incorrect.  They won't tell us what they think is incorrect about 63075.    I think I will have to appeal with the 63075.  Thanks!


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