Neurosurgery Coding Alert

New Jersey Subscriber

Answer: There is insufficient information to provide specific coding guidance. The location of the spinal mass (extradural, intradural/extramedullary, or intradural extramedullary) as well as its nature (neoplastic or non-neoplastic) would be required to determine which regional spine code would be appropriate among codes 63265 (Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical) - 63285 (Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical). The nature of the plates and screws (lateral mass fixation or osteoplastic laminectomy with reconstruction) would be required to determine if the fixation is reported as 22842 (Posterior segmental instrumentation [e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires]; 3 to 6 vertebral segments [List separately in addition to code for primary procedure]), assuming at least 3 points of fixation or 63295 (Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure [List separately in addition to code for primary procedure]).

While not described in the question, this type of procedure may also be performed with microdissection 69990 (Microsurgical techniques, requiring use of operating microscope [List separately in addition to code for primary procedure]), 22600 (Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment), and 22614 (Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment [List separately in addition to code for primary procedure]) for additional levels, and bone graft harvest.