Neurosurgery Coding Alert

Question: Our physician completed a laminectomy on L5 and a hemilamin-ectomy on L4, but the pairing comes back with a bundling edit. What is the best way to code the surgery?

New Mexico Subscriber

Answer: The interspace code 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) is an integral part of the vertebral segment code 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).

Bottom line: 63047 includes removal of disc material above and/or below the vertebra being explored. Your only option in this case is to report 63047 if the surgeon worked on L4-L5.