Neurosurgery Coding Alert

Question: Please suggest a code for dissection of extensive epidural scar tissue.New York SubscriberAnswer: There is no specific code for describing dissection of epidural scar tissue. This work is typically part of a definitive procedure involving decompression, such as when dissecting scar tissue from prior lumbar discectomy to treat a recurrent disc herniation coded as 63042 (Laminotomy [hemilaminectomy], with decompression of nerve root[s]), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar) or when performing a lumbar laminectomy for recurrent stenosis coded as 63047 (Laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (e.g., spinal or lateral recess stenosis)], single vertebral segment; lumbar). The actual microsurgical dissection, when performed with an operating microscope, can be reported with 69990 (Microsurgical techniques, requiring use of operating microscope [List separately in addition to code for primary procedure]).