AHA Coding Clinic® for HCPCS - 2021 Issue 3; Ask the Editor

Lumbar laminoplasty/re-exploration

Patient with a history of prior lumbar (L4-L5) laminectomy, anterior cervical discectomy and fusion, now presents for treatment of significant stenosis at the L3-L4 and L4-L5 levels with neurogenic claudication. Two small laminotomies were created to visualize the interlaminar space. Bilateral laminoplasty decompression of the spinal canal at L3 and L4 was performed by removing the ligamentum flavum, lamina and some of the facet joint. At the previous laminectomy site at L4-L5, scar tissue was identified and dissected at the facet joints at L4-L5 level bilaterally to allow visualization of the lamina. Two laminotomies were created at L4, a medial facetectomy was performed and deep dissection was utilized to remove additional scar tissue. This was performed on both sides. What is the appropriate code(s) for the bilateral lumbar laminoplasty and a revision laminectomy? ...

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