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Reader Question: Don't Equate Laminectomy and Laminoplasty

Question: How should I report an open-door laminoplasty? I can't find a code for it.
  
Illinois Subscriber

Answer: You can't find a code for open-door laminoplasty because CPT doesn't have one. To describe this procedure, your best choice is to report 22899 (Unlisted procedure, spine). Include an operative report and a letter of explanation with your claim so your insurer can see that 22899 was the most accurate code to use.

You may also help your case by comparing this procedure to 63001 (Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or diskectomy, one or two vertebral segments; cervical) or 63015 (... more than two vertebral segments; cervical) and showing how open-door laminoplasty is different.

During a laminectomy, the physician removes the entire spinal lamina at one or more vertebral segments in order to put pressure on the patient's spinal cord. But during an open-door laminoplasty, the physician decompresses the spinal cord while keeping the vertebral column's structural support intact.

-- Reader Questions reviewed by Sarah L. Goodman, MBA, CPC-H, CCP, president of SLG Inc. Consulting in Raleigh, N.C.