kimmcelderry@gmail.com
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In addition to PSF, the phys states he performed a Ponte osteotomy L5-S1 and a laminectomy, facetectomy, foraminotomy of L5, S1 and S2. I know the 22212 is bundled with 63047 (L5-S1) But what about the S2?
"Attention was directed towards the Ponte osteotomies at L5 S1 where there was pseudoarthrosis; after excising the interspinous ligament there, undercutting the lamina above and below, and opening the foramina bilaterally using the Kerrison. I then proceeded to doing the Ponte osteotomy to get some correction of the patient's sagittal malalignment, after entering the canal, I went ahead and excised all remaining ligamentum flavum and then carried out excision of the SAP and partial excision of the IAP on both sides allowing for some correction at that level.
Then attention was directed toward decompression of the area of L5 and S1 down to S2 given the fracture and displacement that led to compression of the cauda equina in that area. So I found the edges of the prior laminectomy at L5 and then proceeded distally using the rongeur Leksell, and then the Kerrison carrying out the decompression widely down to S2 including foraminotomies bilaterally at both L5-S1 and S1-2. The edges of the fracture at S1-2 were exposed all the way across from on both sides of the ala to allow for bony apposition and to improve the chances of healing."
Any advice on how to code a 63047 on S2? Unlisted?
"Attention was directed towards the Ponte osteotomies at L5 S1 where there was pseudoarthrosis; after excising the interspinous ligament there, undercutting the lamina above and below, and opening the foramina bilaterally using the Kerrison. I then proceeded to doing the Ponte osteotomy to get some correction of the patient's sagittal malalignment, after entering the canal, I went ahead and excised all remaining ligamentum flavum and then carried out excision of the SAP and partial excision of the IAP on both sides allowing for some correction at that level.
Then attention was directed toward decompression of the area of L5 and S1 down to S2 given the fracture and displacement that led to compression of the cauda equina in that area. So I found the edges of the prior laminectomy at L5 and then proceeded distally using the rongeur Leksell, and then the Kerrison carrying out the decompression widely down to S2 including foraminotomies bilaterally at both L5-S1 and S1-2. The edges of the fracture at S1-2 were exposed all the way across from on both sides of the ala to allow for bony apposition and to improve the chances of healing."
Any advice on how to code a 63047 on S2? Unlisted?