# Laminectomy code - What is the most appropriate code



## AHVC (Apr 22, 2010)

What is the most appropriate code for the anesthesiologist for a laminectomy with a harrington rod insertion?

Not my forte at all....


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## RebeccaWoodward* (Apr 22, 2010)

For the laminectomy, I would begin looking at the 63001---series.  For the harrington rod, look at 22840.

You mentioned anesthesiologist so I'm not sure if you need an anesthesia code...


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## AHVC (Apr 22, 2010)

Looking for the anesthesia codes, not surgical.


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## hgolfos (Apr 22, 2010)

00670 is for procedures using instrumentation.


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## roshrom (Aug 6, 2010)

*HCPCS code for Spinal Instrumentation for 22840-22842 CPT*

Could anyone advise --if there is one--a HCPCS supply code for the
posterior segmental or non-segmental instrumentation (e.g. spinal rods like Harrington rod) ?
Most hospitals have this information on the chargemaster, but I am working for a facility that has coders bill for the supplies that are normally
included for inpatient procedures on the chargemaster.

Thank you much
Sherry


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## amecey (Aug 12, 2010)

*Spacers*

I am wondering if you can use the 00670 when disk spacers are used??? Are the spacers concidered to be instrumentation???


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## dav4code (Aug 12, 2010)

amecey said:


> I am wondering if you can use the 00670 when disk spacers are used??? Are the spacers concidered to be instrumentation???


 
What is the CPT code, that will help determine. Was more than one vertebral segment operated on?

According to the ASA crosswalk "Code 00670 is appropriate if the procedure is performed with spinal instrumentation, on multiple vertebral levels, or with an add-on code indicating multi-level procedures."

It's important you get it right because 00670 has 13 base units as opposed to 00630


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## amecey (Aug 12, 2010)

*Disk Spacers*

Not sure of the CPT code just wondering if the spacer itself is concidered to be instrumentation. I use them a lot and I want the 00670 if I canget it for those procedures *because* it is worth more.


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## fredcpc (Dec 15, 2010)

*Laminectomy and Harrington for Anesthesia*

So, to summarize, if you have CPT 63001 (laminectomy) + 22840 (insertion of Harrington rods) the only anesthesia code needed is a 00670?


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## NaliniAAPC (Dec 15, 2010)

Hi,
For Laminectomy with Harrington rod use anesthesia code 00670(Instrumentation).you can use 63001 0r 63005 , 22840 with 00670 cross.
Regards,
Nalini CPC


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## fredcpc (Dec 15, 2010)

*Laminectomy and Harrington for Anesthesia*

Thanks Nalini,

It was provided, personally by the Anesthesiologist, and on a otherwise healthy patient, so I added the modifiers too....and got  00670-AA-P1. Do you agree?


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## NaliniAAPC (Dec 15, 2010)

Hi,
Yes you are correct, but i am not sure about the P1 modifier,  check the physical status in anesthesia record ?

Regards,
Nalini CPC


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## fredcpc (Dec 15, 2010)

*Laminectomy and Harrington for Anesthesia*

P1 means normal healthy patient. I got it from Ingenix Encoder. Do think it is something else?


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## NaliniAAPC (Dec 15, 2010)

ohs.. ..you are correct.

Regards,
Nalini CPC


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## dwaldman (Dec 16, 2010)

In regards, to the additional question on this thread about HCPCS supply code for spinal instrumentation, I copy and pasted below this notation I found on Medtronic's Spineline

Hospital > C-Codes for Spinal Devices 

Hospitals are required to use C-codes to report certain drugs, biologicals and devices used in conjuction with outpatient procedures billed and paid for under the Medicare Hospital Outpatient Prospective Payment System (HOPPS).

While there may be C-codes that are appropriate for describing a few of Medtronic Sofamor Danek's technologies, the technologies' indication and application in instrumented spine procedures precludes the assignment of a C-code to the products.


C-codes report devices used in conjunction with outpatient procedures billed and paid for under Medicare HOPPS (outpatient procedures only). 

All instrumented spine procedures are on Medicare's "Inpatient List." The inpatient list specifies those services that are only paid when provided in an inpatient setting. 

Because instrumented spinal procedures are "inpatient only" and C-codes represent devices used in an outpatient setting, C-codes do not exist for MSD's products. 
For further information, please contact the SPINELINE® (hospital and physician coding/billing support) at (877) 690-5353 or spinalcodinghospital@medtronic.com.


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## fredcpc (Dec 16, 2010)

*Laminectomy and Harrington for Anesthesia*

Thanks, Nalini. I feel better now.


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