Anesthesia Coding Alert

Question: A fellow coder told me that we can now bill the 00670 instrumentation code for multiple levels of spinal surgery. Is this true?

Minnesota Subscriber

Answer: Yes, a multiple level (add-on) code might allow you to crosswalk to 00670 (Anesthesia for extensive spine and spinal cord procedures [e.g., spinal instrumentation or vascular procedures]). According to the 2011 Relative Value Guide®, "Code 00670 is appropriate if the surgical procedure is performed with spinal instrumentation, on multiple vertebral levels, or with an add-on code indicating multi-level procedures."

Scenario: The anesthesiologist is involved with a patient's laminectomy surgery represented by 63047 (Laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root{s}, {e.g., spinal or lateral recess stenosis}], single vertebral segment; lumbar). The surgeon treats levels L2, L3, and L4. Because 63047 is a single-level code, remember 63048 (...each additional segment, cervical, thoracic, or lumbar [List separately in addition to code for primary procedure]) for the second and third segments treated.

Code it: If the surgeon only had accessed a single level, you would report 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) for your anesthesiologist, which carries 8 base units. However, you can report 00670 because the surgeon treated multiple vertebral levels during the procedure. Code 00670 carries a base unit value of 13.