Neurosurgery Coding Alert

Question: May I charge extra for use of a CO2 laser during diskectomy? For instance, is there an add-on code to describe use of the laser, or can I append modifier -22 to the diskectomy code?

New Mexico Subscriber 

Answer: No, you should not charge extra for use of CO2 laser during diskectomy.  CPT contains no code - add-on or otherwise - to describe this procedure. Nor can you justify appending modifier -22 (Unusual procedural services) to any diskectomy code: The laser does not add difficulty or time to a standard diskectomy.

You should choose a diskectomy code based on the surgeon's approach. For percutaneous surgery, report 62287 (Aspiration or decompression procedure, percutaneous, of nucleus pulposus of intervertebral disk, any method, single or multiple levels, lumbar [e.g., manual or automated percutaneous diskectomy, percutaneous laser diskectomy]).

For an open anterior approach, report 63075 (Diskectomy, anterior, with decompression of spinal cord and/or nerve root[s], including osteophytectomy; cervical, single interspace) with +63076 (... cervical, each additional interspace [list separately in addition to code for primary procedure]), as appropriate, for additional levels.