Neurosurgery Coding Alert

Question: How do we report the following? Decompressive Laminectomies Total L3, partial L2-L4 Bilateral Forminotomy L2-3 and Redo L3-4 Only Dural Graft with PAM Is it correct to report 63047 (Laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [e.g., spinal or lateral recess stenosis], single vertebral segment; lumbar)? How do we capture the bilateral foraminotomy? Kansas Subscriber Answer: You would correctly report 63047 for the L2-3 level and 63048 for the L3-4 level. If there was significant additional time spent as a consequence of the prior surgery, you may report both codes with the -22 modifier. Code 63042 (Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, re-exploration, single interspace; lumbar) is intended for re-exploration discectomy.