Reader Question:
Laminectomy With Dural Tear May Warrant -22
Published on Wed Mar 17, 2004
Question: If our orthopedist performs a laminectomy and repairs a dural tear at the same level, can we report a separate code, or is the repair part of the surgical global package?
Missouri Subscriber Answer: The orthopedic surgeon normally cannot bill additional codes for such complications during surgery. In this case, the payer will consider repair of a small dural tear part of the surgery package.
But if the surgeon must perform a significant repair -- such as one that requires additional bone removal for exposure and/or graft application -- you can append modifier -22 (Unusual procedural services) to the appropriate laminectomy code. You should ask the surgeon to write a letter detailing the aspects of the procedure that went above and beyond a normal laminectomy procedure.
-- You Be the Coder and Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopaedic Associates in New Brunswick, N.J.