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Hi all! I'm needing help understanding how to code a tumor treatment by a multilevel laminectomy and a single vertebral body posterior corpectomy. My initial thought was to go with 63276 and an unlisted to represent the posterior corpectomy. One of my doctors suggested using LECA codes (63101), but I'm not sure if this is suitable; I know laminectomies are included in the LECA codes but the corpectomy was only done on one vertebral body. Pertinent documentation below. Will most likely be asking for a better description of the corpectomy.
Patient has metastatic spinal cancer. Doctor performed T8-10 laminectomies with a transpedicular corpectomy of T9 (33%).
Any guidance will help this headache go away! Also if anyone has dependable neurosurgery educational resources they use on the regular, I'd love to hear them!
.... I then proceeded to perform a laminectomy overlying the tumor location first with the AM8 drill to drill
troughs bilaterally from T8 through T10 bilaterally. I then removed the lamina in
between with the combination of the AM8 and the Kerrison. I then proceeded to remove the
rest of this bone and then I carefully dissected with a combination of Woodson and micro
dissector to carefully dissect the remainder of the tumor away from the thecal sac. I
then proceeded to drill down the left pedicle at T8 so that I could carefully dissect and
send tumor to pathology. I then proceeded to further evacuate
and resect more tumor away from the thecal sac as well as drill further transpedicular to
remove all the tumor that was transpedicular. Once I felt I had fully decompressed the spinal canal I placed screws....
I performed all complex portions of this procedure including T8-T10
laminectomy for resection of extradural malignant tumor as well as transpedicular partial
corpectomy at T9 on the left greater than 33% of the bone and then posterior segmental
instrumentation with posterolateral arthrodesis fusion using stereotactic navigation and
morselized allograft....
Patient has metastatic spinal cancer. Doctor performed T8-10 laminectomies with a transpedicular corpectomy of T9 (33%).
Any guidance will help this headache go away! Also if anyone has dependable neurosurgery educational resources they use on the regular, I'd love to hear them!
.... I then proceeded to perform a laminectomy overlying the tumor location first with the AM8 drill to drill
troughs bilaterally from T8 through T10 bilaterally. I then removed the lamina in
between with the combination of the AM8 and the Kerrison. I then proceeded to remove the
rest of this bone and then I carefully dissected with a combination of Woodson and micro
dissector to carefully dissect the remainder of the tumor away from the thecal sac. I
then proceeded to drill down the left pedicle at T8 so that I could carefully dissect and
send tumor to pathology. I then proceeded to further evacuate
and resect more tumor away from the thecal sac as well as drill further transpedicular to
remove all the tumor that was transpedicular. Once I felt I had fully decompressed the spinal canal I placed screws....
I performed all complex portions of this procedure including T8-T10
laminectomy for resection of extradural malignant tumor as well as transpedicular partial
corpectomy at T9 on the left greater than 33% of the bone and then posterior segmental
instrumentation with posterolateral arthrodesis fusion using stereotactic navigation and
morselized allograft....