Zirpoli9306
Contributor
We have been billing for our partial corpectomies using CPT code 63081, our operative codes do not indicate the percentage of the vertebral body removed; however, it is listed as "partial corpectomy was performed...". For the past few months, Oxford has been denying the 63081 stating that as per Orthonet, 63081 is not substantiated and are suggesting that we use 22551 instead. Our surgeon got on the phone with a medical director at Orthonet and argued the fact that he did perform a partial corpectomy and that he was using the correct code. The medical director told him that in order to bill 63081, there has to be more than 50% of the vertebral body removed. This guideline is written on the AANS guideline going back to 2004.
My question is; the code description of 63081 on the CPT book does not give an indication as to the percentage of the vertebral body that needs to be removed. Do we have to go by the AANS guideline? Our surgeon totally disagrees with this guideline. Where do we go from here?
My question is; the code description of 63081 on the CPT book does not give an indication as to the percentage of the vertebral body that needs to be removed. Do we have to go by the AANS guideline? Our surgeon totally disagrees with this guideline. Where do we go from here?