Appendix A -
I GUIDELINES FOR NECK AND BACK PROCEDURES.
a) Co-Surgeons:
Add surgeons fee + 20% assist's fee divided by 2 to calculate payment for each surgeon.
b) Co-Surgeons exposing for an anterior approach:
- All cervical approaches - 10 units
- All thoracic approaches - 12 units
- All abdominal approaches - 10 units
c) Bilateral posterior laminotomies (63030) will be paid 100% for the first side and as an extra interspace (63035) for the opposite side.
d) Microscopes on routine laminectomies are an option and NOT compensable. (This is a surgeon's preference and/or standard of care)
(e) The removal of posterior segmental fixation with exploration as a single procedure will be paid per the added code of 22853 = 18 units.
(f) If a surgeon cuts the dura during routine laminectomy, Workers' Compensation will not pay for the repair.
(g) Bilateral spinal facet injections will be compensated on code 64442 and 64443 for the bilateral side. Each additional injection site will be paid on code 64443. The local injection is included in the primary injection procedure.
(h) For spinal injection procedures 76000 will be compensated for the use of the fluoroscope.
(j) For spinal injection procedures, hard copy x-ray (professional component) charges are included in the primary injection procedures. Technical component will be paid per the St. Anthony's.