Neurosurgery Coding Alert

Question: CPT instructs to include modifier 50 to indicate bilateral completion of 63030. Do we report one code with modifier 50, or report the code twice and include modifier 50 on the second line?

Connecticut Subscriber

Answer: The payer's guidelines dictate how to include modifier 50 (Bilateral procedure) to 63030 (Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, including open and endoscopically-assisted approaches; 1 interspace, lumbar) or other procedures on your claim.

Example: Many insurance companies pay when you bill on one line as 63030-50 with two units of service. Workers' compensation carriers in Connecticut, however, require 63030 on line one and 63030-50 on line two. Your local guidelines should explain the payer's preference.