Neurosurgery Coding Alert

Question In a patient with tethered cord at T9-T10 with scar tissue at T12-L1, our surgeon removed the T12 spinous process lamina and did a decompression along with scar tissue removal. Then he did a T8 spinous process removal with decompression. At around T9, where the cord was tethered to the dura with extensive scar (along with tethering of dura), our surgeon sutured a dural patch. How do we report these procedures?

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Answer For release of tethered cord, you report code 63200 (Laminectomy, with release of tethered spinal cord, lumbar). You may also report +69990 (Microsurgical techniques, requiring use of operating microscope [List separately in addition to code for primary procedure]) for the microdissection performed, if any. It is unclear why the T12 laminectomy was performed. This may or may not be separately reportable if the nature of the decompression was unrelated to the tethered cord.