Wiki Lumbar Spine diskectomy reexploration

[Ccgerson]

I'm new to neurosurgery coding, and not sure how to code this scenario:
Patient has a LEFT L4/L5 laminotomy, foraminotomy with discectomy (63030) in November. Two months later (still in global period), patient has a "Redo LEFT L4/5 laminotomy, foraminotomy with discectomy for recurrent HNP, AND RT L4/5 laminotomy, foraminotomy with discectomy"
The LEFT side had a lot of scar tissue, so lysis of adhesions was done and discectomy could not be done on that side. Right side was then done, with disc fragments excised. The surgeon also crossed over the midline in order to retrieve disc fragments that couldn't be reached through scar tissue with the left sided approach.
Is this 63042-78, LT AND 63030-78 (or no 78?), RT

Thank you,
Cindy

 

[mschaller]

In order to use 63042 the patient has to be out of the global period. You would definitely use 63030. My question is if you can now bill 63030 79 RT. With the disc herniation now on the right side is that considered an unrelated problem? I don't think you would be able to bill anything for the left side unless he removed it from the left side. I'm sure you have to use 63030 but I'd like to hear others opinions on the modifiers and the bilateral aspect.