Neurosurgery Coding Alert

Question: Our provider performed a C3-C5 laminoplasty in addition to a NewBridge Laminoplasty Fixation System. What CPT® code should I use? And should I bill separately for a laminectomy and morselized allograft?

Montana Subscriber

Answer: Based on the description, you should apply code 63051 (Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements [including the application of bridging bone graft and non-segmental fixation devices (eg, wire, suture, mini-plates), when performed]). If the provider had not utilized the fixation system, you would apply code 63050 (Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments) instead.

As is explained in the code description for 63051, the code includes the application of fixation devices, such as mini-plates. The NewBridge Laminoplasty Fixation system utilizes specialized titanium plates to hold the allograft in place, so this fixation system would not be coded separately. Additionally, you should not code separately for a laminectomy, as it is included in the procedure description of 63051.

There is also a Correct Coding Initiative (CCI) edit in place explaining that 63051 and 63045 (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; cervical) should only be coded together if performed during separately identifiable encounters.

However, you may code the allograft separately using code +20930 (Allograft, morselized, or placement of osteopromotive material, for spine surgery only [List separately in addition to code for primary procedure]).