Neurosurgery Coding Alert

Question: What is an -open-door- laminoplasty, and how should I code this procedure?

Mississippi Subscriber
 
Answer: During an open-door laminoplasty, the surgeon leaves portions of the posterior elements intact, hence the name.
 
This differs from other posterior decompression codes, which account for removal of the posterior spinal elements (e.g., 63001, Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy [e.g., spinal stenosis], one or two vertebral segments; cervical; and 63015, Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy [e.g., spinal stenosis], more than two vertebral segments; cervical).
 
When your neurosurgeon performs an open-door laminoplasty, choose from these two codes depending on the encounter specifics:

- 63050 -- Laminoplasty, cervical, with decompression of the spinal cord, two or more vertebral segments

- 63051 -- ... with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [e.g., wire, suture, mini-plates], when performed).