Neurosurgery Coding Alert

Reader Questions:

Select Site for Metastasis in Spine

Published on Fri Mar 25, 2011

Question: If the procedure planned is T7-T9 laminectomy for a metastatic carcinoma, is the code 63266 (Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic) appropriate?

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Answer: The correct code in this situation would be dependent upon the location of neoplasm in the spine, whether intradural or extradural and if extra- or intramedullary. The codes can hence be 63276 (Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic) 63281 (Laminectomy for biopsy/ excision of intraspinal neoplasm; intradural, extramedullary, thoracic) or 63286 (Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic), or 63290 (Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level). Since secondary carcinomas to the spinal region but not the bones themselves typically metastasize to the epidural (extradural) space, code 63276 is most likely the correct choice.

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