I do agree with 63047. This is a Q/A that you may find helpful.
Question: The spine surgeon performs a Left L5 hemilaminectomy and left L5 decompressive foraminotomy for spinal stenosis. Do you report 63030 or 63047? If 63047, please explain why, when from what I can tell, a full laminectomy is not being performed. What is the difference between 63030 and 63047 other than how much of the lamina is being removed?
I recently got clarification on this issue from CPT, and wanted to share this information with you, because it represents a departure from the thinking I previously had on laminectomy and laminotomy coding.
Previously, I would have told you that the difference between a laminectomy (63047) and a laminotomy (63030, also sometimes called a hemilaminectomy) is in the amount of bone removed.
However, CPT has clarified that there are additional factors the coder must consider when selecting 63030 vs. 63047. Let's start by looking at the full descriptors for the codes:
-63030 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disk; one interspace, lumbar (including open or endoscopically-assisted approach)
-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
As you can see, both codes include facetectomy and foraminotomy, however there are some key differences between the codes, CPT explained.
The big difference is the purpose of the procedure: You should report 63030 when laminotomy is performed with a diskectomy, to treat spinal disc herniation using either an open procedure or under endoscopic assistance, CPT says.
The code was revised starting in 2000 to this use, as explained in the November 1999 CPT Assistant:
"Code 63030 has been revised to clarify the appropriate reporting of this code for use when performing laminotomy for diskectomy using endoscopic assistance."
In addition, 63030 is a unilateral code, and should be reported for the first occurrence of disc herniation, CPT explains.
By contrast, Code 63047 is used to report procedures performed for lateral recess stenosis, for example, caused by either ligamentum flavum hypertrophy or facet arthropathy.
CPT explains that laminectomy is a surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. The surgeon removes or trims the lamina to widen the spinal canal and create more space for the spinal cord and spinal nerves.
It would be appropriate to report 63047 for the procedure, even though it describes a partial laminectomy only of the left lamina and foramen. The purpose of the procedure is to relieve spinal stenosis, which is the primary use of 63047.
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