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  1. Post 63056/63047
    Medical Coding Books
    The codes I came up for this proceudre are 63056/63047 & 69990. I couldn't find anything where 63056 & 63047 were bundled. But wasn't too sure if they could be performed at the same level or not. I know the foraminotomy was performed & don't think that is included in the 63056. Any insight is appreciated!!

    1. Extraforamenal L5-S1 partial lateral facectomy with decompression of the dural sac, foraminotomy and discectomy at L5-S1 on the left.
    2. Microdissection using the operating room microscope.
    DETAILS OF THE PROCEDURE: The patient was taken into the operating room and placed under general endotracheal anesthesia. The patient was positioned carefully with the appropriate padding and rolls, and placed in a prone position. The lumbar region was shaved, prepped and draped in the routine fashion. Incision was marked out at the L5-S1 level in the paraspinous region. This was opened sharply to the skin and subcutaneous and subperiosteal dissection was carried out at the appropriate level. The 60mm Harmony port retractor was placed in the room and secured to the side of the table. X-rays were taken to confirm the L5-S1 level.

    With microdissection the lateral facet, transverse process was identified. A lateral facetectomy was performed with the Midas Rex drill. The ligamentum flavum was removed with the punches over the L5 root laterally. The disc in the lateral and extraforamenal compartment was identified. There was a fim sompressive herniated disc identified.
    The annulus was incised with a 15 blade. The herniated proion of the disc was removed. The disc was endplates were almost opposed and no internal disc could be removed. The L5 rtoot was well decompressed and free in the foramen, a moarked improvement.

  2. #2
    Fayetteville, NC
    69990 is a component code of both 63056 and 63047. It can not be billed with either one ever. Per Payer Path it cannot be billed using a modifier.

    Code / Description
    63056 DECOMPRESS SPINAL CORD M Non-Facility RVU: 43.51

    63047 REMOVAL OF SPINAL LAMINA M Non-Facility RVU: 32.23

    69990 MICROSURGERY ADD-ON M Non-Facility RVU: 6.48

    Code 69990 is a component of Column 1 code 63056 and cannot be billed using any modifier.
    Code 69990 is a component of Column 1 code 63047 and cannot be billed using any modifier.
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

  3. Default
    I would not bill 63047 and 63056 at the same level. This issue has come up at many coding seminars, even though it isnt considered bundled, the intent of the procedure is doing the transforaminal discectomy. I would bill 63056 only.

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