Neurosurgery Coding Alert

Question: Our patient had a LT lumbar discectomy in November 2010. He has had recurrent herniation at the same level, same side and is back for a revision laminotomy with discectomy. Should I report 63042 (Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar)? And does recurrent = reexploration?California SubscriberAnswer: Code 63042 is only appropriate after the patient is out of the 90-day global period. Otherwise, you would use 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) and append modifier -78 (Unplanned return to operating room...) and 76 (Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other [...]