Neurosurgery Coding Alert

Question: My physician did a T5 and T6 corpectomy (63101, Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment, and 63103, each additional segment (List separately in addition to code for primary procedure)) and additional laminectomy for a tumor at T4 and T7. He wants to verify whether or not he can bill 63276 (Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic) in addition to 63101/63103. Is this correct?

Answer: You would not additionally code for the neoplasm biosy/excision. In general, a single decompression code is applied to each level. The lateral extracavitary decompression codes include laminectomy, facetectomy and excision of the pedicle. Biopsy or excision of neoplasm in the extradural space would  be incidental to the extracavitary decompression. However, if an intradural neoplasm were biopsied or resected using a lateral extracavitary approach, then an additional code to describe the intradural excision would be appropriate, as this would not be considered incidental to the lateral extracavitary decompression. The specific code would depend upon the location of the intradural lesion.