Neurosurgery Coding Alert

Question: During microlaser diskectomies the neurosurgeons use a CO2 laser. I use 66821 to bill this because I have been unable to find a specific laser code for spinal. Is there a better code to use?

Minnesota Subscriber

Answer: Code 66821 (discission of secondary membranous cataract [opacified posterior lens capsule and/or anterior hyaloid]; laser surgery [e.g., YAG laser, one or more stages]) is a cataract eye code and should not be used. Once a coder realizes that an error has been made, any monies received must be refunded and the billing corrected.

Coding varies according to how the procedure was performed. If it is done percutaneously, consider 62287 (aspiration or decompression procedure, percutaneous, of nucleus pulposus of intervertebral disk, any method, single or multiple levels, lumbar [e.g., manual or automated percutaneous diskectomy, percutaneous laser diskectomy]).

If it is done as an open anterior procedure, wherein an incision is made on the front side area of the neck, 63075 (diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace) and 63076 (... cervical, each additional interspace [list separately in addition to code for primary procedure]) are possible.

Note: The choice of instrument used for an open procedure (such as a laser instead of a scalpel) does not justify additional compensation. If a laser is used in any kind of open diskectomy, code for the procedure only.