Neurosurgery Coding Alert

Question: If our surgeon does a transpedicular discectomy and a redo laminectomy, medial facetectomy at the same level, are both 63056 (Transpedicular approach with decompression of spinal cord, equina and/or nerve root[s] [e.g., herniated intervertebral disc], single segment; lumbar [including transfacet, or lateral extraforaminal approach] [e.g., far lateral herniated intervertebral disc]) and 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) billable?

California Subscriber

Answer: No, you cannot bill together for 63056 and 63047. The work in the transpedicular code also includes facetectomy and laminectomy at the same level.  While both can be billed together when performed at separate levels, modifier 59 (Distinct procedural service) would need to be appended to the laminectomy code to distinguish the separate anatomical site.