Wiki 63030, 22612, 22630, and 63047 performed together

[tygerlily]

Hi,

Can anyone give me some info. on how to appeal a denial when a laminotomy (63030), laminectomy/decompression (63047), interbody arthrodesis (22630) and posterolateral arthrodesis are all performed at the same surgery? Sometimes they are done at the same levels, but my neurosurgeon goes above and beyond the usual procedure, and we use the proper modifiers.

Thank you

 

[cmrq866]

The only way I believe is that the opnote needs to be very detailed and explain each procedure if they are separately identifiable. I have trouble with 22630/63047 combo( I cannot get medicare to pay). Dr needs to state in the opnote that the 63047 was separately performed(it's own paragraph). Modifier -59 can be used

 

[tygerlily]

Thank you so much. Am new to neurosurgery and the procedures can be quite tricky. Thanks again!