Neurosurgery Coding Alert

Question: One of our surgeons performed a decompressive laminectomy for a patient in 2001. Another surgeon in our practice performed decompressive laminectomy on the same patient in 2005. I billed the second procedure with modifier -77, and the payer reduced our reimbursement because of the modifier.

My question is: When is it appropriate to report modifier -77?


Pennsylvania Subscriber


Answer: You should report modifier -77 (Repeat procedure by another physician) when another physician repeats a procedure on the same day. The modifier alerts the payer that you have not mistakenly reported the procedure twice.

The decompressive laminectomy (for example, 63001, Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or diskectomy [e.g., spinal stenosis], one or two vertebral segments; cervical) in 2005 isn't really a "repeat" of the same procedure in 2001, as described by modifier -77.

In this case, you should contact the payer and inform it of your error: Your surgeon deserves full reimbursement for the laminectomy.