Neurosurgery Coding Alert

Question: One of our physicians performed a partial corpectomy at T-11 and a partial corpectomy at T-12. Im not sure how to report this. Should I report a corpectomy and an additional level? If not, how should I code it?

Kentucky Subscriber

Answer: The answer depends on whether the neurosurgeon performed the corpectomy for an intrinsic bony lesion or for decompression -- and that affects your coding.

If the procedure was for a bony lesion, you should use 22112 (Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root[s], single vertebral segment; thoracic) with +22116 (... each additional vertebral segment [List separately in addition to code for primary procedure]).

If the neurosurgeon used the corpectomy for decompression, however, you would use 63085 (Vertebral corpectomy [vertebral body resection],partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root[s]; thoracic, single segment) and +63086 (... thoracic, each additional segment [List separately in addition to code for primary procedure]).

You should note, however, that you should use the corpectomy codes for removal of the vertebral body from the rostral to the caudal disc space. In the thoracic spine, your physician must remove more than one third of the vertebral body to use these codes. If the physician does a partial vertebral corpectomy in the course of an extended anterior diskectomy and decompression (for instance, removal of endplates and osteophyte), you should not report the corpectomy code.