Minimally invasive decompression laminectomy with diskectomy at L4-5 on left/with a twist

carol52

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Fayetteville, Arkansas
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Hello, I have a laminectomy listed above : an incision was made over the space of L4-5 and the area was exposed. A decompressive laminectomy was carried out with high speed drill and Kerrison rongeurs.
The ligamentum flavum was slightly hypertrophied adding to stenosis it was excised in piecemeal fashion. Due to facet hypertrophy, medial facetectomy was carried out followed by medial foraminotomy. there was a largely calcified herniated disk that was
encountered, only a small amount of disk material was able to be excised due to calcification, the central disk was unable to be excised.
My question is with the disk not being able to be completely excised can I not code the 63030 with a reduced modifier ?
Thanks
Carol
 
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Virginia Beach, VA
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63047-Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root, [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar
 

carol52

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Fayetteville, Arkansas
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63047-Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root, [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar
Is this because the disk was not removed or because this was laminectomy, facetectomy and foraminotomy is that why the 63047 was used and not the 63030. The more I read the more confused I become.
Would appreciate your feedback
Thanks,
Carol
 

iowagirl77

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Cedar Rapids, IA
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Generally if the laminectomy was done for stenosis, I'd go with 63047. If they have both stenosis and herniated disk, I'd still go with 63047 (63030 bundles to it at the same level). If only herniated disk, then I'd go with 63030.
 
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