Neurosurgery Coding Alert

Answer: Rhonda Petruziello, CPC, reimbursement specialist for neurosurgery at Cleveland Clinic Foundation in Cleveland, says that whenever 63075 (diskectomy, anterior, with decompression of spinal cord and/or nerve root[s], including osteophytectomy; cervical, single interspace) and 22554 (arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace [other than for decompression]; cervical below C2) are billed together, 63075 should be appended with a -51 modifier. The -51 modifier tells the carrier that this procedure is a multiple procedure done at the same setting on the same day and would be subject to a 50 percent reduction in reimbursement as a result. The intent of the neurosurgeon is to decompress the nerve root by removing the disc, which is described with 63075. Code 22554 is used primarily to describe anterior arthrodesis but includes the verbiage minimal diskectomy to prepare the interspace for the fusion. Simply stated minimal diskectomy does not usually describe the decompression procedure adequately.