# procedure code 66056



## hankweiss (Jul 6, 2014)

Doctor is performing an arthroscopic discetomy in the office. Billing with code 66056. Has anyone ever used this code. Insurance companies don't like it. Please let me know. Thank you


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## OCD_coder (Jul 6, 2014)

I am not finding 66056 in the CPT book for 2014.  It could very well be a T-code such as 0274T, 0275T; but we can't tell from the lack of information.  The fact that is was performed in the office (POS 12) is interesting as it may not be allowed in the office and must be performed in an ASC setting (outpatient).  Does the carrier consider it a non-covered service and experimental?

Was a laser involved?
Laproscopic Laser Discectomy 62287

This article might be of assistance for you:
https://www.healthpartners.com/public/coverage-criteria/minimally-invasive-spine-procedures/


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## hankweiss (Jul 7, 2014)

*endoscopic discectomy*

Thank you for you help, unfortunately I do not have any additional information, but what you gave me was extremely helpful


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## dwaldman (Jul 8, 2014)

CPT 63056 lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)

You need to immediately inform those involved that 63056 is only reported for an open surgical approach. That reporting CPT 63056 would be incorrect coding of endoscopic approach and would result in overpayment. If payment has been received, need to refund and rebill would the correct codes for endoscopic approach.

CPT 63056 is not recognized as a procedure that can be reported for endoscopic approach.

See below for coding guidance from AMA CPT Assistant

July 2012 page 3

Spine and Spinal Cord Code Changes

Injection, Drainage, and Aspiration

The descriptor language of code 62287 now not only reflects a combination of services performed at a single or multiple lumbar level(s), but also continues to represent a percutaneous as opposed to an open surgical approach (eg, 63030, 63056) for the aspiration of disc tissue from the disc interspace under fluoroscopic guidance utilizing any needle-based technique and/or endoscope. 




62287

Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with the use of an endoscope, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar

(This includes endoscopic approach)


For nonneedle-based technique for percutaneous decompression of nucleus pulposus of intervertebral disc, see codes 0274T and 0275T. 

When visualization is only endoscopic and/or image-guided for percutaneous laminectomy procedures, the procedure is percutaneous and should be reported with new Category III codes 0274T and 0275T. Percutaneous decompression procedures of the intervertebral disc/nucleus pulposus of intervertebral disc that utilize needle-based techniques should be reported with code 62287. 

Endoscopically assisted laminotomy (hemilaminectomy) procedures require open and direct visualization. If the visualization is performed via endoscope and/or image guidance, the procedure is considered to be percutaneous. In these circumstances, codes 0274T and/or 0275T are to be reported for the laminotomy procedure performed. When the instrument is used in any fashion without direct visualization of the neurologic structures by naked eye/ microscope and/or loupe magnification, then it would be consistent with a percutaneous laminectomy. CPT codes are developed to best describe a surgical technique and not a specific device and/or instrument. 

The descriptors of codes 63020-63035 were revised to omit references to "open and endoscopically assisted approaches" to further differentiate the use of these codes when laminotomy or hemilaminectomy are performed using an open surgical approach. To illustrate, code 63030 may be reported only when an open surgical technique (not only an endoscopic approach/technique) is used, and when the intrinsic essential components of this code are performed, namely, a resection of the vertebral component, spinous processes, and lamina, which must include a discectomy for decompression of the nerve root(s), as well as any laminotomy, laminectomy, or foraminotomy along with partial facetectomy as needed for decompression of the nerves, or required as part of the surgical approach. The repair of a small intraoperative dural laceration or leak, and the harvesting and placement of a soft tissue graft, muscle, or fat when obtained from within the primary surgical incision are considered as part of the intraservice work and are not reported separately. If laminotomy with decompression of nerve root(s) is not performed, it would not be appropriate to report code 63030 for the excision of the herniated intervertebral disc.


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