Neurosurgery Coding Alert

Question: How does one report the placement of interspinous spacer during a posterior arthrodesis? A bilateral laminectomy and foraminotomy was done at L3/L4 with a posterior arthrodesis and placement of interspinous spacer and an allograft?

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Answer: The scenario described does not include the number of nerves decompressed and the location of the posterior arthrodesis. Assuming that only the L4-5 level was decompressed with bilateral L4 foramintomies and a posterolateral transverse process arthrodesis was performed, 63047 (Laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]], single vertebral segment; lumbar) would describe the decompression and 22612 (Arthrodesis, posterior or posterolateral technique, single level; lumbar [with or without lateral transverse technique]) the posterior arthrodesis. The addition of an interspinous allograft for fusion would be included in 22612.