Laminoplasty Scenarios

Question:

In our spine practice, we often see different laminoplasty scenarios for coding. Is it ever appropriate to report decompression in addition to laminoplasty (63051)? Hope you don’t mind, but I have included a couple of commonly seen laminoplasty scenarios from our practice that we are eager for KZA’s opinion. 

Scenario #1 Our surgeons wish to bill 63051 for laminoplasty (C4-C6) and 63020 & 63035 for foraminotomies (C4/5 & C5/6) because they say it's a significant amount of work. We struggle with this one, is this appropriate? 

Scenario #2 Laminoplasty performed from C4-C6, and decompression performed at C2/3?   

Scenario #3 Laminoplasty performed from C4-C6 with partial laminectomies performed at C3 & C7.  

Answer:

 Great questions and scenarios!  Most importantly, laminoplasty codes should not be reported with arthrodesis, instrumentation, decompression, or osteoplastic reconstruction at the same vertebral segment.  Meaning, if the laminoplasty is from C4-C6 and the foraminotomies are performed at C4/C5 & C5/C6, only CPT 63051 is reported.    

Scenario #1 CPT 63051 is only reportable.  

 * KZA is not addressing the accuracy of CPT code 63020/63035 for a foraminotomy in non-related cases. 

Scenario #2 CPT 63051 & 63045-59 (distinct separate procedure) or XS modifier, as directed by your payor to reflect decompression, was performed at a separate level from laminoplasty.    

Scenario #3 Only CPT 63051 is reportable, the partial laminectomies above and below the laminoplasty are considered included to complete the laminoplasty. 

*This response is based on the best information available as of 10/31/24.