Neurosurgery Coding Alert

Question: Which CPT code should we report when the surgeon performs a reduction of spondylolisthesis during a lumbar procedure? He usually documents this when he performs a fusion, instrumentation insertion or laminectomy with decompression.

Florida Subscriber

Answer: Unfortunately, you cannot separately report the spondylolisthesis reduction that the surgeon performed during the lumbar procedures.
 
Most insurers would consider the spondylolisthesis incidental to the main procedure (the fusion, instrumentation insertion or laminectomy).
 
The payer would most likely reason that the spondylolisthesis is automatically "reduced" when the surgeon inserts the rods, and you therefore cannot separately collect for the reduction. Put another way, no surgeon would fixate vertebrae in a misaligned condition, so the lumbar procedure is not "complete" without the reduction.
 
 - Clinical and coding expertise for You Be the Coder and Reader Questions provided by Eric Sandhusen, CHC, CPC, director of compliance for the Columbia University department of surgery.