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Orthopedic Coding Alert

Reader Questions:

Keep Mod 50 Off of Bilateral Laminectomy Claim

Published on Tue Sep 23, 2008

Question: If the surgeon performs a bilateral lumbar laminectomy, should I append modifier 50? Washington Subscriber Answer: No. All laminectomy codes, including 63001-63017, 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) and +63048 (... each additional segment, cervical, thoracic or lumbar [list separately in addition to code for primary procedure]), describe either unilateral or bilateral procedures. In addition, the CMS fee schedule assigns these procedures a bilateral status indicator of "2," which means "payment adjustment does not apply because relative value units assume the procedure is bilateral." Result: You may not append modifier 50 (Bilateral procedure) to report a procedure on both the left and right side of the spine.
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