Neurosurgery Coding Alert

Question: Is the laminectomy included in the T12 burst fracture code?

North Dakota Subscriber

Answer: CPT includes a note after codes 22325- +22328 (Open treatment and/or reduction of vertebral fracture[s] and/or dislocation[s], posterior approach, 1 fractured vertebra or dislocated segment ...) that states, "For decompression of spine following fracture, see 63001-63091 ..." That leads you to think that you should select a decompression code from 63001-63091 (codes for laminectomy, laminotomy, discectomy, or vertebral corpectomy with decompression) instead of a fracture treatment code. Treatment of the fracture (including reduction of dislocation and laminectomy) is included in codes 22325-+22328.

Catch: The Correct Coding Initiative (CCI) edits, however, do not indicate a bundling issue with the fracture and decompression codes. That means payers should accept both codes for the surgery when performed at different levels, especially if they follow CCI edits. Before submitting your claim, check with the payer's representative to be sure you follow the correct guidelines.