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Neurosurgery Coding Alert

Reader Questions:

Watch 22214 With Decompression Services

Published on Sat Oct 02, 2010

Question: I have two similar cases that I need help coding:1st case: L4-5 decompression, bilateral L4 pars osteotomies w/correction of spinal deformity. L4-5 lumbar interbody fusion2nd case: L4-S1 decompression, bilateral L4 pars osteotomies w/ correction of spinal deformities L4-5 interbody fusionMy question is, for the first case, if the surgeon performed osteotomies on L4 and did a complete decompression on L4-5, how would this be billed? I have the same question on the 2nd case: If the surgeon performed an osteotomy on L4 and complete decompression on L4-S1, how would this be billed?Wisconsin SubscriberAnswer: Global services for the osteotomy procedure (22214, Osteotomy of spine, posterior or posterolateal approach, 1 vertebral segment; lumbar) include the decompression, so you would not report 63047 (Laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [e.g., spinal or lateral recess stenosis]), single vertebral segment; lumbar) or 63048 [...]
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