Laminectomy facetectomy w/decompression

Hi Dr. Coded;
63045,63048;22600;22614;22842;22210;22216 x2;69990;20926;20660;20936;20934;76000

I am getting a denial on the 63045 and 63048 the rest either paid correctly or are not payable. Please help

re: LAMINECTOMY FACETECTOMY W/DECOMPRESSION

Can you copy the op report and paste it here? Or at least put write down the exact procedure as it is written.

re: LAMINECTOMY FACETECTOMY W/DECOMPRESSION

This article has a wealth of information:


http://static.aapc.com/a3c7c3fe-6fa1-4d67-8534-a3c9c8315fa0/e0bdf19e-6a7c-4179-9300-8acc467f224e/14b41494-5432-4b85-bd42-460a42a054f1.pdf

re: LAMINECTOMY FACETECTOMY W/DECOMPRESSION

Hello Linda,

You have been a plethora of resource and data, I was hoping I might pick your brain if you have familiarities regarding workers comp claims and referral networks.

At your convenience feel free to contact me at turanga@adva-net.com or if you prefer directly @ 941.313.3293, we might have some mutual interests and networking opportunities.

Thanks,
Todd

re: LAMINECTOMY FACETECTOMY W/DECOMPRESSION

There are so many things wrong with the billed codes - and that's just looking at the code combinations.

CPT® 20660 is included in all spine procedures - you have to stabilize the head in order to operate on the spine so you should not bill for it. CPT® 20660 says "(separate procedure)" anyway.

CPT® 76000 is included in all open spine codes and should not be billed.

CPT® 20934 doesn't exist.

CPT® 20926 is probably inappropriate - why was a separate fat graft used for spine surgery? If to plug an incidental durotomy, then it's not billable. If obtained through the same incision, it's not billable.

CPT® 63045/63048 should not be billed with 22210/22216 - they are mutually exclusive codes.

Sounds like spine procedure coding education would be of help. We can help or look at your specialty society (such as AANS, AAOS) for coding courses.

Kim Pollock, RN, MBA, CPC
Consultant
KarenZupko & Associates, Inc.
www.karenzupko.com

re: LAMINECTOMY FACETECTOMY W/DECOMPRESSION

Hi Kim,
I hope to see you this year in Orlando! Anyone from Codapedia going to the AANS Managing Coding and Reimbursement meeting?

re: LAMINECTOMY FACETECTOMY W/DECOMPRESSION

Yes, I will be in Orlando teaching the AANS Coding Course - see you there!

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com