Neurosurgery Coding Alert
Weigh Your Deskectomy Options Carefully
Question: A neurosurgeon in my group documented that he performed an anterior lumbar diskectomy, but I don't see a code that I can use to report that procedure. How should I code it?
New Jersey Subscriber
Answer: Although a code exists for an anterior thoracic diskectomy, there is no code for an anterior lumbar diskectomy. You have two options for reporting this procedure, and which you choose depends on what your carrier wants.
First, you could report an unlisted-procedure code, namely 64999 (Unlisted procedure, nervous system) in this case. Refer to the RVUs for the analogous code (63077, Diskectomy, anterior, with decompression of spinal cord and/or nerve root[s], including osteophytectomy; thoracic, single interspace) to set a rate for the service, noting that the anterior lumbar diskectomy most closely matches the procedure your surgeon performed.
Because of the real similarities of the two codes, your second option is simply to report 63077 and append modifier 22 (Unusual procedural services) to indicate that the surgery was different from what the 63077 code descriptor details. Specify -lumbar, not thoracic- in the comments portion of your claim.
Bottom line: Check with your individual carriers to see how they want you to report an anterior lumbar diskectomy.
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