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LECA & Lami?
Our practice is slightly confused. In the setting of a LECA corpectomy, is a laminectomy separately reportable? Can KZA provide some clarity for our practice?
Question:
Our practice is slightly confused. In the setting of a LECA corpectomy, is a laminectomy separately reportable? Can KZA provide some clarity for our practice?
Answer:
Thank you for asking KZA!
Identifying the intent of the laminectomy is essential.
A lateral extracavitary corpectomy (LECA) includes laminectomy for access. If the laminectomy is performed just for the approach and access to the anterior spine, it should not be reported in addition to the LECA corpectomy – this is included.
In instances where a separate tumor is present, such as an extradural tumor, and a laminectomy is required to resect the posterior portion of the tumor, this may be reported separately and in addition to the lateral extracavitary corpectomy (LECA).
*This response is based on the best information available as of 7/17/25.
Facet Wedge?
Our surgeon used a facet wedge device at C1-C2 and then performed facet arthrodesis with instrumentation. How would I code the facet wedge?
Question:
Our surgeon used a facet wedge device at C1-C2 and then performed facet arthrodesis with instrumentation. How would I code the facet wedge?
Answer:
Thank you for contacting KZA with an inquiry!
The codes for posterior intrafacet implants (facet wedge/dowel arthrodesis) are Category III codes: 0219T (Cervical, 0220T (Thoracic), & 0221T (Lumbar). These codes include imaging and placement of bone grafts, synthetic devices, and arthrodesis.
Based on the presented scenario, if a facet fusion is performed and documented, it would not be appropriate to report 22600 instead of or in addition to 0219T. CPT provides a list of codes not to report in conjunction with at the same level. This is appropriately reported with 0219T.
*This response is based on the best information available as of 7/03/25.
Amount of Lamina Removed for a Laminectomy
I'm pretty new to neurosurgery coding and could use some help. Is there a specific amount or percentage of lamina that must be removed in order to code 63047?
Question:
I'm pretty new to neurosurgery coding and could use some help. Is there a specific amount or percentage of lamina that must be removed in order to code 63047?
Answer:
No. Surgeons usually try to remove as little lamina as possible – just enough to relieve pressure on the nerve. A specific amount does not need to be documented.
*This response is based on the best information available as of 6/19/25.
Instrumentation Removal vs. Exploration
My coder told me that if spinal instrumentation is removed and exploration performed but nothing else done, we would code for exploration but not for the removal of instrumentation. Why wouldn't we bill instrumentation removal vs. exploration?
Question:
My coder told me that if spinal instrumentation is removed and exploration performed but nothing else done, we would code for exploration but not for the removal of instrumentation. Why wouldn't we bill instrumentation removal vs exploration?
Answer:
When spinal instrumentation is removed for the purpose of exploration, we would code the exploration CPT code 22830; the instrumentation removal is included in the exploration.
*This response is based on the best information available as of 6/05/25.
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