Neurosurgery Coding Alert

Question: How do we code for two levels where our surgeon did microlaminotomies and PLF fusion with interspinous instrumentation?

North Carolina Subscriber

Answer: There is insufficient information provided to offer accurate coding advice. Assuming an open approach for microlaminotomy, you may be able to report 63047 for the first nerve root level decompressed and 63048 if another root level was decompressed; Assuming you use PLF to refer to posterior lumbar fusion, you would need to specify whether a posterolateral 22612 or posterior lumber interbody (22630) fusion was performed..

When reporting microlaminotomy and PLF, you count the number of interspaces treated to report the correct number of codes. You report one code for one interspace.

Finally, you may report the instrumentation. You report +22841 (Internal spinal fixation by wiring of spinous processes [List separately in addition to code for primary procedure]). Remember that some payers like Medicare may bundle 22841 into the primary procedure and you may not earn separately for both codes.