Orthopedic Coding Alert

You can avoid laminoplasty denials if you submit a detailed letter with your claim. Include information about the procedure and an explanation of how you selected your charges. You can use the following letter as a guide when drafting your own:

To: Smith Insurance
Re: Patient John Doe

Dear Sir or Madam:

Attached is a copy of my operative report and bill on the above-referenced patient. There is no CPT code for cervical laminoplasty; therefore, I am reporting the unlisted-procedure code for the spine, 22899. 
 
This procedure is somewhat like code 63001, Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or diskectomy (e.g., spinal stenosis), one or two vertebral segments; cervical. The procedure involves two lengthwise cuts on either side of the spinous process. On one side the cut is made completely through the lamina, while on the other side it is partially cut through, creating a "hinge." The bone is "opened" like a door on its hinge, and a small piece of bone is placed to hold it open. This has the effect of enlarging the canal. The procedure differs from code 63001 in that the lamina is not removed
 
Kindly base your reimbursement for this procedure on your allowed amount for CPT code 63001. If you have any questions, please do not hesitate to contact me. 

     Sincerely yours,
     Michael Jones, MD