Anesthesia Coding Alert

Question: One of our providers uses 00630 for a lumbar microdiscectomy. Can the procedure qualify for 00670 and earn additional RVUs?

Minnesota Subscriber

Answer: Your provider is correct in reporting 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) for a lumbar microdiscectomy, unless documentation supports the "extensive procedure" requirement of 00670 (Anesthesia for extensive spine and spinal cord procedures [e.g., spinal instrumentation or vascular procedures]).

Difference: CPT includes 00670 for spinal instrumentation or multiple levels. CPT does not include a concrete definition of "extensive," but some experts say to consider any spinal surgery involving more than one level "extensive." Also, check the operative notes for details such as "lumbar laminectomy at L4/5, L5/S1" or "lumbar laminectomy with instrumentation." Both of these cases would point to 00670, which carries 13 relative value units (RVUs) instead of the 8 RVUs associated with 00630.