Orthopedic Coding Alert

Question: Our surgeon used an operating microscope for dissection during single-level decompression, hemilaminectomy, and partial facetectomy in the lumbar region. Can we bill both the procedure and microscope use since the patient is non-Medicare?

North Dakota Subscriber

Answer: You can report both codes if the payer's guidelines allow it. If so, submit 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) and +69990 (Microsurgical techniques, requiring use of operating microscope [List separately in addition to code for primary procedure]).

Edit watch: The Correct Coding Initiative (CCI) edits bundle +69990 into 63030 and do not allow you to break the bundle with a modifier. Many individual payers also have policies stating that the microscope use is an inherent part of 63030. If the payer in question follows CCI edits or has its own policy bundling the services, you can only file with 63030.