Neurosurgery Coding Alert

Answer: The information you have provided is insufficient to make a definitive determination.  If your surgeon performed the procedure under direct visualization of the disc and nerve root with the naked eye, you report codes 63056 (Transpedicular approach with decompression of spinal cord, equina and/or nerve root[s] [e.g., herniated intervertebral disc], single segment; lumbar [including transfacet, or lateral extraforaminal approach] [e.g., far lateral herniated intervertebral disc]) and +69990 (Microsurgical techniques, requiring use of operating microscope [List separately in addition to code for primary procedure]). If however, direct visualization was not possible and your surgeon performed an endoscopic or percutaneous discectomy, the most appropriate code that you can report is 62287 (Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with the use of an endoscope, with discography and/or epidural injection[s] at the treated level[s], when performed, single or multiple levels, lumbar).  The x-ray obtained for localization would be considered inclusive in either of these services.