Neurosurgery Coding Alert

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Question: Our surgeon has begun using a CO2 laser during diskectomies, but other than 66821 I have not been able to find a laser code in CPT. How should I report the procedure? Arizona 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]) describes use of a laser during eye surgery and is not appropriate for diskectomy. Rather, appropriate coding for the diskectomy depends on how the surgeon performed the procedure. For a percutaneous surgery, report 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]). For an open anterior procedure, report 63075 (Diskectomy, anterior, with decompression of spinal cord and/or nerve root[s], including osteo-phytectomy; cervical, single interspace) with +63076 (... cervical, each additional interspace [list separately in addition to code for primary procedure]), as appropriate. The use of a laser during an open procedure does not justify additional compensation. No additional coding, or the use of modifier -22 (Unusual procedural services), is appropriate.