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Lumbar discectomy open or percutaneous

  1. Default Lumbar discectomy open or percutaneous
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    Our surgeon wants to bill the following procedure using cpt 63030, but I feel according to the description this surgery is really not an "OPEN" discectomy but rather a percutaneous discectomy in which case I am not sure what CPT code to use because CPT codes 0275T nor 62380 really doesn't fit either. Maybe 62287 or unlisted code? I am not sure on this one. Thanks!

    Procedure: Left sided L3-L4, and L4-L5 invasive tubular discectomy.

    Patient placed prone on a Wilson frame, arms were protected, all bony prominences were carefully padded, low back was prepped and draped in usual sterile fashion, a needle was placed in the L3-L4 disc space from approximately 45 degrees oblique, a discogram was done using Isovue and Isogreen and showed a clear tear in the L3-L4 disc with extensive dye spread, next, a percutaneous small incision was made over the needle, A guidewire was placed in the L3-L4 disc space and dilating tube was placed into guidewire was placed in the L3-L4 disc space and dilating tube was placed into the L3-L4 disc space. Next pituitary rongeur was used to create a far lateral discectomy at L3-L4, Multiple fragments of disc material were removed. An electrocautery was used to cauterize the annulus and the disc. A 40mg of Depo Medrol as well as Marcaine were injected into the disc and the dilating tube was removed. Next the exact same procedure was done at L4-L5 via separate incision. Wounds were copiously irrigated. Both the two wounds were closed using a nylon suture.

  2. #2
    Fort Myers, FL
    Definitely percutaneous. AANS says to look at 0274T or 0275T.
    Sara Boyce, CPC, CPMA, SRS, AAPC Associate
    Neurosurgical Coder

  3. Default
    My question with using that code is that it states a "Laminectomy" was included, and the op report doesn't states that a laminectomy/laminotomy was performed? Thank you!

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