Redo Laminectomy Denials (63042 & 63044)

Question:

I am having trouble coding a redo laminectomy. Most get denied, and my surgeon does them all the time. CPT codes 22633 or 22612 are usually the primary codes. I'm still confused about 63042 & 63044. Thank you.

Answer:

Thank you for asking KZA!

This inquiry did not include an operative note or denial information. Without this, KZA will provide some general coding guidance.

If the diagnosis is not disc-related, codes 63042 & 63044 would not be appropriate to report with codes 22633 or 22612. Additionally, CPT code 22633 includes discectomy; it would not be appropriate to report 63042. These could be the source of the denials received.

Key Takeaways:

• Laminectomy coding is diagnosis-driven. Generally, reviewing the pre-/postoperative diagnoses and indications will provide this detail; if not, querying the surgeon is advised for clarification.

• There are only reexploration codes for disc (6304x). If the diagnosis is not disc, Modifier 22 could be potentially considered if the documentation reflects and supports additional procedural services.

• Lumbar interbody fusion codes (22630-22634) – include discectomy (63030/63035 & 63042/63044).

• Lumbar interbody fusion codes (22630-22634) have add-on codes (63052/63053) to reflect additional decompression beyond laminectomy/discectomy sufficient to prepare the interspace.

*This response is based on the best information available as of 8/28/25.

63081 or Something Else?

Question:

I received feedback from an external review and am now confused. A partial cervical corpectomy (30%) was documented and reported with CPT 63081, along with fusion and instrumentation. I’ve been informed that this is not a corpectomy. I'm looking for confirmation that this is correct feedback.

Answer:

Thank you for asking KZA!

CPT defines the minimum amount of bone removed for partial corpectomies—the minimum amount for the cervical spine is at least one-half (50%).

The feedback received is correct, as the documented 30% does not support reporting a partial corpectomy. Instead, this is appropriately reported as an ACDF, CPT 22551.

*This response is based on the best information available as of 8/14/25.

63266 & 63267 - Reported Together?

Question:

If the provider removed an epidural abscess from T4-T9 via one incision and then did a separate incision at L4-5, can I bill CPT 63266 and 63267?

Answer:

Thank you for asking KZA!

Remember, the laminectomy for non-neoplasm code set (6326x and 6327x) are regional codes, meaning they include any number of contiguous laminectomies.

The key in the scenario is that these laminectomies were performed via two separate incisions; additionally, they are non-contiguous (T4-T9 and L4/L5). Yes, both codes (63266 & 63267) may be reported as described by the scenario in this inquiry.

*This response is based on the best information available as of 7/31/25.

LECA & Lami?

Question:

Our practice is slightly confused. In the setting of a LECA corpectomy, is a laminectomy separately reportable? Can KZA provide some clarity for our practice?

Answer:

Thank you for asking KZA!

Identifying the intent of the laminectomy is essential.

A lateral extracavitary corpectomy (LECA) includes laminectomy for access. If the laminectomy is performed just for the approach and access to the anterior spine, it should not be reported in addition to the LECA corpectomy – this is included.

In instances where a separate tumor is present, such as an extradural tumor, and a laminectomy is required to resect the posterior portion of the tumor, this may be reported separately and in addition to the lateral extracavitary corpectomy (LECA).

*This response is based on the best information available as of 7/17/25.

Facet Wedge?

Question:

Our surgeon used a facet wedge device at C1-C2 and then performed facet arthrodesis with instrumentation. How would I code the facet wedge?

Answer:

Thank you for contacting KZA with an inquiry!

The codes for posterior intrafacet implants (facet wedge/dowel arthrodesis) are Category III codes: 0219T (Cervical, 0220T (Thoracic), & 0221T (Lumbar). These codes include imaging and placement of bone grafts, synthetic devices, and arthrodesis.

Based on the presented scenario, if a facet fusion is performed and documented, it would not be appropriate to report 22600 instead of or in addition to 0219T. CPT provides a list of codes not to report in conjunction with at the same level. This is appropriately reported with 0219T.

*This response is based on the best information available as of 7/03/25.

Amount of Lamina Removed for a Laminectomy

Question:

I'm pretty new to neurosurgery coding and could use some help. Is there a specific amount or percentage of lamina that must be removed in order to code 63047?

Answer:

No. Surgeons usually try to remove as little lamina as possible – just enough to relieve pressure on the nerve. A specific amount does not need to be documented.

*This response is based on the best information available as of 6/19/25.