Orthopedic Coding Alert

Question: Encounter notes indicate that the surgeon performed hemilaminectomy on spinal segments C3-C5. The surgery also included nerve root decompression, partial facetectomy (C3-C4), and excision of a herniated disc (C4-C5). Should I report 63020 x 2?

Nevada Subscriber

Answer: No. There is an add-on code for additional vertebral segments your surgeon might treat during these hemilaminectomies.

On your claim, report 63020 (Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical) for the C3-C4 hemilaminectomy and +63035 (… each additional interspace, cervical or lumbar (List separately in addition to code for primary procedure)) for the C4-C5 hemilaminectomy.

Bonus info: You’ll also use +63035 if the surgeon performs one of these hemilaminectomies on a patient’s lumbar region (63030 [… 1 interspace, lumbar]). And, if your surgeon performs one of these hemilaminectomies bilaterally, you’ll append modifier 50 (Bilateral procedure) to the surgery code.