63042/63030-51

tmarugg

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The patient underwent a "revision L5-S1 decompression/microdiskectomy". Diagnosis "Lumbar radiculopathy with scar tissue formation and intractable pain" From the op note "...recent MRI of the lumbar spine demonstrated significant scar tissue in & around the S1 nerve root..."

Would the use of modifier -51 on the on the initial discectomy be correct? According to CCI edits, the codes are mutually exclusive. Or should we not bill the 63042 redo discectomy?

Thank in advance!
 
I would bill the redo code only...the code represents the build up of the scar tissue and the RVU's are much higher. Hope this helps
 
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