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Neurosurgery Coding Alert

Reader Questions:

Modifier 59 Paves the Way for Arthrodesis-Laminectomy Pay

Published on Thu May 10, 2007

Question: Our surgeon performed a posterior interbody arthrodesis for a patient at L1-L2 and L2-L3. During the same session, she also performed a laminectomy at T4. How many codes should we report for this encounter?

Arkansas Subscriber  Answer: You-ll report three CPT codes and a modifier for these services:
 
- 22630 (Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace [other than for decompression], single interspace; lumbar) for the L1-L2 arthrodesis
 
- +22632 (- each additional interspace [list separately in addition to code for primary procedure]) for the L2-L3 interspace arthrodesis
 
- 63046 (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;
thoracic) for the laminectomy

 - modifier 59 (Distinct procedural service) attached to 63046 to show that the laminectomy and the arthrodesis are separate services provided at separate sites.
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