Neurosurgery Coding Alert

Question: My doctor is performing a 63278 (Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral) but it is at three levels. Can I use this code three times to show the three levels or would I just use it once?

Answer: The main thing to consider is the amount of additional work that is involved in the procedure. If there were extenuating circumstances, such as adhesions to get through, etc., you might be able to get more by using a 22 modifier, but the documentation has to be exceptionally detailed to get this. Also, the code itself is not designated to a specific number of levels, so you would use this code once to describe the levels in that section of the spine, as code 63278 is a regional code that describes one or more levels of laminectomy.