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Neurosurgery Coding Alert

Spinal Decompression Update:

Finesse Your MILD Coding With These Refinements

Published on Tue Feb 08, 2011

See how turning to 63030, 63047 could trip you up.Accurately reporting minimally invasive lumbar decompression (MILD) procedures with open and endoscopic techniques just got a little bit easier. When your neurosurgeon performs a MILD, follow this scenario and coding advice offered in the November 2010 CPT Assistant.Scenario: Through a small incision and using fluoroscopic guidance, the surgeon performs an epidurogram to identify the specific lumbar stenosis location, followed by a small laminotomy and decompressive resection of the ligamentum flavum to treat the patient's central canal spinal stenosis.Question: Should you report 63030 or 63047 for this procedure?Answer: No, you would report these services with "unlisted spine code, 22899 or 64999, Unlisted procedure, nervous system," CPT Assistant explains. The rationale is that the "MILD procedure involves a fluoroscopic, needle-based procedure without direct visualization of critical neural structures," CPT Assistant states. MILD procedure devices "are not intended for disc procedures" but should be [...]
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