Neurosurgery Coding Alert

Question: May we append modifier -50 for bilateral lumbar laminectomy? Nevada Subscriber Answer: All laminectomy procedures, including 63001-63017, 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)] ...) and +63048 (... each additional segment, cervical, thoracic or lumbar [list separately in addition to code for primary procedure]), include unilateral or bilateral procedures, as specified in the code descriptors. Further, the CMS fee schedule assigns these procedures a bilateral status indicator of "2" (payment adjustment does not apply because relative value units assume the procedure is bilateral). Therefore, you may not append modifier -50 (Bilateral procedure) to report a procedure on both the left and right side of the spine.