Find CPT® and ASA Crosswalk Solutions for Discectomy Coding
Question: How should I code anesthesia services for a discectomy? Oklahoma Subscriber Answer: For a cervical discectomy we are directed to CPT® codes 63075 (Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace) and +63076 (… each additional interspace (List separately in addition to code for primary procedure)). These codes crosswalk to 00600 (Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace) or 00670 (Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace) in the American Society of Anesthesiologists (ASA) crosswalk. Report 00600 for a procedure with a single interspace without instrumentation. If instrumentation is used, or there are multiple vertebral segments (minimum three vertebral bodies with two associated interspaces) involved, then report 00670. If an osteotomy or total disc arthroplasty is performed as well as the discectomy, other surgical CPT® codes may apply, but the anesthesia crosswalk for those codes follow the same principles: Report 00600 for a single interspace, and report 00670 if instrumentation is used or there are multiple vertebral bodies with the associated interspaces involved. For a thoracic discectomy we are directed to CPT® codes 63077 (Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace) and +63078 (… each additional interspace (List separately in addition to code for primary procedure)). These codes crosswalk to 00625 (Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace), with 00626 (Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace) as an alternate. The coding is determined by whether one-lung ventilation was used during the procedure. A thoracic discectomy may be performed during another procedure to prepare the interspace. These scenarios may instead crosswalk to a 00620 (Anesthesia for procedures on the thoracic spice and cord; not otherwise specified) — making it essential to carefully review all CPT® descriptions to determine the correct surgical CPT® code, and then find the corresponding anesthesia code. For a lumbar discectomy, several CPT® codes may apply, but they all generally follow the same anesthesia crosswalk principles. Code 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) is for a procedure with a single interspace without instrumentation, with an alternative of 00670 for a procedure with instrumentation or multiple vertebral segments involved. In all anesthesia coding scenarios, accurately determining the correct surgical CPT® code is the important first step in selecting the appropriate anesthesia code. Careful attention should be given to the alternate codes listed and the reasoning behind when and why to apply these alternate codes. Julie McDaniel, MHA, CPC, CANPC
