I have been billing spine surgeries for quite some time and work closely with the North American Spine Society. I have been getting denied codes 63047, 63048 when billed with 22633. I have been using the 59 modifier on 63047, 63048 if the operative note says decompression of neural elements was performed. The spine book mentions that Decompression 63047 is unlikely reportable unless there has been more laminectomy and neural element decompression is performed. Has anyone else had this issue? I don't bill 63047 and 63048 if the discectomy was performed to prepare the interspace; I only bill if its for documented decompression. Does anyone have any other feedback that I can send to the insurance companies to appeal?