Neurosurgery Coding Alert

Reader Question:

Do Not Report Laminectomy Code With 63655

Question: Can we bill together for a laminectomy for decompression of nerve roots done at the same side of spinal cord stimulation (SCS) implant? The patient had a spinal stenosis in the thoracic region and the SCS was placed at the same level. The patient's OP report mentions "laminectomy from T9-T10, AMA drill was used to further expand the laminectomy for decompression. A set of instruments was used to complete neurolysis at this level......" New York SubscriberAnswer: The code 63655 (Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural) includes the laminectomy done to implant the electrodes. You cannot report the laminectomy codes like 63003 (Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy [eg, spinal stenosis], 1 or 2 vertebral segments; thoracic) with 63655 at the same level.
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