Laminotomy (cervical code 63020 or lumbar code 63030, with the add-on code for each additional level as +63035; unilateral): This is the most common spine procedure performed. In these procedures, part of the lamina is removed on one side to allow access to the spinal cord. Use the -RT and -LT or -50 modifiers with these codes. If a disk has ruptured, fragments or the part of the disk compressing the nerves are removed. A partial removal of a facet or removal of bone around the foramen may also be performed to relieve pressure on the nerve. The lumbar approach may be performed as either an open or endoscopic procedure.
Endoscopic procedure: In an endoscopic approach, a small guide probe is inserted under fluoroscopic guidance. Using magnified video, as well as fluoroscopic guidance, the endoscope is manipulated through the foramen and into the spinal canal. When the guide probe is in the surgical site, a larger tube is manipulated over the guide probe. Instruments are advanced through the hollow center of the tube. Herniated disk fragments are removed and the disk is reconfigured to eliminate pressure on the nerve roots. The same codes discussed above (63020 and 63030) are used for the endoscopic technique.
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