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Q: neurosurgery of burst fracture ( Answered,   0 Comments )
Subject: neurosurgery of burst fracture
Category: Health > Medicine
Asked by: khanmaria-ga
List Price: $50.00
Posted: 03 Mar 2004 17:39 PST
Expires: 02 Apr 2004 17:39 PST
Question ID: 313140
What is the CPT code for a "laminectomy of T11 and T12 with reduction
of T12 vertebral body bone fragments."  The diagnosis was burst
fracture of T12 .
The op report reads:  I removed the posterior spinous process of
T12and a portion of the Posterior spinous proces of T11.  The lamina
of T12 and portion of the lamina of T11 wee removed in the following
fashion.  I used a Ledksell to carefully thin the bone down and then
used the drill to finish drilling dow to the yellow ligament.  The
ligament was carefull traversed and removed piecemeal.  Laminectom was
carried out to the pedicle on both sides exposing the thecal sac from
the disc space of Tll, l2 and just aboveto the dsc\sc space of T12 and
L1.  I will appreciate an answer to this question as it will settle an
argument once and for all.  Thank ou

Request for Question Clarification by crabcakes-ga on 03 Mar 2004 18:18 PST
Hi khanmaria,

Can you tell me why this procedure was performed? Was it because of a
degenerative disease, or for pain relief?

Any additional information you have will be helpful in feterning the
correct code(s).

What insurance do you have?

To be clear, you don't want or need ICD9 codes, only CPT codes, right?

When was this surgery performed?

Clarification of Question by khanmaria-ga on 04 Mar 2004 08:54 PST
The insurance is Blue Cross.  This is a 24 year old who fell and
landed on his buttocks.  He had a significant compromise of the spinal
canal and deformity of the spine.  Two surgeons performed the surgery.
 The neuro did the portion I described and the ortho placed the rods. 
I do not need the ICD-9 codes.  Both surgeries were treated as
separate surgeries not with one doc assisting. Hope this clarifies.
Subject: Re: neurosurgery of burst fracture
Answered By: bobcooper-ga on 05 Mar 2004 16:35 PST
Dear khanmaria-ga 

The neurosurgeon performed a laminectomy on T12 and a laminotomy
(hemilaminectomy) on T11.  Also, the neurosurgeon performed
foramenotomies by carrying the procedures out to the pedicles.  These
procedures should be coded with CPT codes 63046 Laminotomy,
facetectomy and formanenotomy (unilateral or bilateral with
decompression of spinal cord, cauda equina and/or nerve root(s)),
single vertebral segment; thoracic and 63048 each additional segment.

CPT codes 63001-63017 would not be correct because foramenotomies were
performed.  CPT code 63020-63044 would not be correct because these
were bilateral foramenotomies.

I hope this helps.
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