Neurosurgery Coding Alert
Whats Best for Re-Exploration?
New Hampshire Subscriber
Answer: Rather than 63047 (Laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (e.g., spinal or lateral recess stenosis)], single vertebral segment; lumbar), you should choose 63042 (Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disk, re-exploration, single interspace; lumbar) even if the redo laminotomy extends to create a laminectomy (removal of entire laminar segment).
The code descriptor specifically states re-exploration and therefore includes typical additional work required for operating in an altered surgical field, which may include dissection of scar tissue and adhesions. For this reason, modifier -22 (Unusual procedural services) is not required.
Neurosurgery Coding Alert
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