08/25/17 – New guidelines for Spinal Surgeries

Question: What can providers supply on the billing slip to make coding spine surgeries easier?


Answer: Providers should be supplying all information about the service provided.  This would include multiple levels and instrumentation being used.

Below is a table of some CPT changes.

Type of Approach CPT Definition Associated Decompression and Laminotomy,  Laminectomy procedure codes
Percutaneous “Image-guided procedures, performed with indirect visualization of the spine without the use of any device that allows visualization through a surgical incision. 62287 (Percutaneous decompression of nucleus pulposus of intervertebral disc)


Note-These procedures included imaging guidance.

Endoscopic “Spinal procedures performed with continuous direct visualization of the spine through an endoscope.” 62380 (Endoscopic decompression of spinal cord, nerve root, including laminotomy, partial facetectomy, foraminotomy, discectomy and /or excision of herniated intervertebral disc, 1 interspace, lumbar.)
Open “Spinal procedure performed with continuous direct visualization of the spine through a surgical opening.” 63001-63017, 63045-63048 Laminectomy

63020-63044  Laminotomy

63050, 63051 Laminoplasty

63055-63066  Decompression

Indirect Visualization “Image-guided (e.g., CT or fluoroscopy), not light based visualization.” 62287   This definition applies to percutaneous procedures.
Direct Visualization “Light-based visualization; can be performed by eye or with surgical loupes, microscope or endoscope.” In general, procedures performed under direct visualization are coded as open however, endoscopic procedures such as 62380 would also be considered “direct” visualization, CPT states.


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