Orthopedic Coding Alert
Here are the Codes You Need for New, Recurrent HNP
Question: Our physician performed surgery due to recurrent HNP at L5-S1 and a new HNP at L4-L5. How should we code this?
Hawaii Subscriber
Answer: You’ll report treatment of the recurrent HNP (herniated nucleus pulposus) at L5-S1 with 63042
(Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploraton, single interspace; lumbar). Because the HNP at L5-S1 is recurrent, your surgeon is dealing with a more complicated procedure.
You might be able to append modifier 22 (Increased procedural services) to 63042, depending on the documentation.
Then report 63030 (Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, including open and endoscopically-assisted approaches; 1 interspace, lumbar) for the new HNP.
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