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Official Description

Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar
Short Descr Spine device implant surgery
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(T)
ASC Payment Group Code YY – 1/01/2020
BETOS P6B – Minor procedures - musculoskeletal
TOS Code(s) 1 – Medical care
Added Date 1/1/2020
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
MUE 2
MUE Not applicable/unspecified.
OTS Orthotic No
LT Left side (used to identify procedures performed on the left side of the body)
SG Ambulatory surgical center (asc) facility service
Date
Action
Notes
2024-01-01 Changed Short description changed.
2020-01-01 Added Code added.
Code
Description
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