Excision of Lumbosacral Disc, Open Approach 2016 2017 2018 2019 2020 2021 Billable/Specific Code ICD-10-PCS 0SB40ZZ is a specific/billable code that can be used to indicate a procedure.
Decompression (without discectomy) with removal of lamina, ligamentum flavum with facetectomy and forami-notomy ICD-9 724.02 (Spinal stenosis lumbar region) ICD 10 codes: M48.06 (Spinal stenosis lumbar region) 63047 63048
Two codes are assigned for the anterior spinal fusion, as two levels of the spine were fused (L4-L5 and L5-S1). The codes for the anterior spinal fusion are 0SG00AJ (L4-L5) and 0SG30AJ (L5-S1). Two codes are also assigned for the posterior spinal fusion, 0SG0071 (L4-L5) and 0SG3071 (L5-S1).
Be careful: There is a single combined decompression/fusion code: 22551 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2.
2022 ICD-10-PCS Procedure Code 00NY0ZZ: Release Lumbar Spinal Cord, Open Approach.
Other specified postprocedural states The 2022 edition of ICD-10-CM Z98. 89 became effective on October 1, 2021.
An intervertebral discectomy is surgery to remove all or part of the damaged discs between each vertebra in the spinal column. It is most often done on discs in the lower (lumbar) part of the spine. It may also be done on cervical discs in the neck.
26.
ICD-10-CM Code for Encounter for surgical aftercare following surgery on the nervous system Z48. 811.
Laminectomy (removal of lamina bone) and diskectomy (removing damaged disk tissue) are both types of spinal decompression surgery. Your provider may perform a diskectomy or other techniques (such as joining two vertebrae, called spinal fusion) during a laminectomy procedure.
A laminectomy is a procedure to remove a greater portion of the bone (lamina) covering the roof of the spinal canal. A discectomy is a procedure to remove a portion of a herniated disc in the spine, which is bulging and pushing on a nerve.
Lumbar decompression surgery is a type of surgery used to treat compressed nerves in the lower (lumbar) spine. It's only recommended when non-surgical treatments haven't helped. The surgery aims to improve symptoms such as persistent pain and numbness in the legs caused by pressure on the nerves in the spine.
Laminectomy is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina). This helps ease pressure on the spinal cord or the nerve roots that may be caused by injury, herniated disk, narrowing of the canal (spinal stenosis), or tumors.
CPT Code 63030 is defined as laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; one interspace, lumbar (including open or endoscopically-assisted approach) and; Code 63047, laminectomy, facetectomy and ...
Cervical laminectomy It usually involves removing a small piece of the back part (lamina) of the small bones of the spine (vertebrae). Laminectomy enlarges the spinal canal to relieve pressure on the spinal cord or nerves. Laminectomy is often done as part of a decompression surgery.
Code 20930 is an add on code and used for specified spinal procedures only. Check with your payer to determine if 20930 can be billed separately or if the application of the bone graft material is included in the code for the primary surgical procedure.
Body Part: The body part character reflects the level of the vertebrae (cervical, thoracic, lumbar and/or sacral) and the number of vertebral joints fused. The intervertebral joint is the space that is located between any two adjacent vertebrae. One factor in determining the number of fusion codes to assign is how many levels were fused.
Coding professionals must be able to distinguish between what procedures are integral to a spinal fusion and are not assigned additional codes, versus those not considered to be integral and are assigned separate codes. The following are examples of how to make that distinction.
Decompression is the general term to describe removal of the spinal disk, bone, or tissue causing pressure and pain. Often, this is the only procedure performed. Examples include: laminectomy to decompress spinal canal and/or nerve roots (e.g., 63001-63017, 63045-+63048), discectomy to decompress spinal canal and/or nerve roots (e.g., 63020-+63035, 63040-+63044, 63055-+63057), corpectomy (e.g., 63081-+63091), fracture repair (e.g., 22325-+22328), etc.#N#CPT® designates the decompression codes as being per “vertebral segment” or per “interspace.” Decompression occurs at the interspace for discectomy codes (e.g., right L4-L5 interspace). Discectomy is a single, standalone code, such as 63030 Laminotomy (hemilaminectomy), with decompression of nerve root (s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar.#N#But decompression of the spinal canal can be coded per vertebral segment (63001-63017), or per level of foraminotomy (e.g., decompression of the L4 exiting nerve root via partial laminectomy at L4 and partial laminectomy at L5, with foraminotomy at L4-L5, is reported using one code: 63047 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root [s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar).#N#Discern whether the approach was posterior or anterior to choose the correct code. Table A illustrates commonly used, standalone decompression codes for spine surgery.#N#Table A: Standalone decompression codes for spine surgery
“It seems like coding spine cases is as complicated as doing the surgery,” said a spine surgeon at his first coding training session with me.#N#Spine procedure coding can make even the most confident coder squirm. But spine procedure coding doesn’t have to be difficult. In fact, it’s quite formulaic. Follow these five principles and spine procedure coding will go from scary to simple.
Common areas of confusion include CPT code 63042. Re-exploration at a level with a recurrent disc herniation can only use CPT code 63042. It should only be used after the global period for the first disc surgery has expired. Repeat facetectomy and lateral recess decompression at a level with a prior decompression must use CPT code 63047 if no disc work is per-formed. The presence of a lumbar disc herniation (722.1) drives the CPT code.Another common misconception is code 63047. This code can be used unilaterally or bilaterally as long as the decompression involves the lateral recess and foramen. Posterior fusion codes that involve disc preparation (22630,22633) already take into account the decompression work. Using ad-ditional decompression codes (63005, 63012, 63030,63042, 63047) is not al-lowed.
The use of posterior fusion codes that encompass disc work (eg, 22630 and 22633) already take into account the removal of lamina, facets and ligamen-tum flavum. The interbody fusion codes also were written assuming bilateral interbody placement which requires bilateral decompression. In cases that require decompression plus fusion (L4-5 spondylolisthesis with central and lateral recess stenosis), only the fusion codes can be used.