I think I have confused myself is this considered two levels or one? I know CPT code 63047 states single vertebral segment. HELP!!
Fluoroscopic visualization was used to localize the L3-4 interspace. A midline incision was made, dissecting down through the skin and the subcutaneous tissue. McCulloch retractor was then inserted deep to the tissue. A Kocher clamp was placed over the spinous process and x-rays confirmed 3-4 interspace. At that point in time, an AM8 drill was then used to complete the bilateral decompression, initially removing the lamina of L3. Care was taken to spare 6 mm of pars bilaterally. This was taken off with the AM8 drill, as well as partial spinous process removal. At that point in time, a series of #3 and #4 Kerrison rongeurs were used to elevate and resect the ligamentum. Central decompression was then completed. Ligamentum, as well as the medial aspect of the superior articular facet, was then removed bilaterally, taking no more than 50% of the facet bilaterally, to complete a bilateral recess decompression. Foraminotomy was then performed. At the completion of this, a nerve hook could be passed out with the exiting L3 nerve roots, as well as the traversing L4 nerve root.
Fluoroscopic visualization was used to localize the L3-4 interspace. A midline incision was made, dissecting down through the skin and the subcutaneous tissue. McCulloch retractor was then inserted deep to the tissue. A Kocher clamp was placed over the spinous process and x-rays confirmed 3-4 interspace. At that point in time, an AM8 drill was then used to complete the bilateral decompression, initially removing the lamina of L3. Care was taken to spare 6 mm of pars bilaterally. This was taken off with the AM8 drill, as well as partial spinous process removal. At that point in time, a series of #3 and #4 Kerrison rongeurs were used to elevate and resect the ligamentum. Central decompression was then completed. Ligamentum, as well as the medial aspect of the superior articular facet, was then removed bilaterally, taking no more than 50% of the facet bilaterally, to complete a bilateral recess decompression. Foraminotomy was then performed. At the completion of this, a nerve hook could be passed out with the exiting L3 nerve roots, as well as the traversing L4 nerve root.