2025 CPT code 63020
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Nervous System - Spinal Surgery Surgery Feed
Laminotomy (hemilaminectomy) of one cervical interspace with nerve root decompression, including partial facetectomy, foraminotomy, and/or herniated disc excision.
Modifiers 50 (bilateral procedure), LT (left side), RT (right side), and others may apply depending on the specific circumstances of the procedure.Consult payer guidelines.
Medical necessity is established by clinical findings consistent with nerve root compression, spinal stenosis, or other conditions causing significant neurological symptoms.Documentation must support the need for surgical intervention and justify the specific procedure performed.
The neurosurgeon or spine surgeon is responsible for performing the laminotomy, decompression, facetectomy, foraminotomy, and discectomy, as appropriate.Pre-operative and post-operative care may involve other healthcare professionals.
In simple words: The doctor removes part of a bone in the neck (cervical spine) to relieve pressure on a nerve.This may involve removing a small part of a nearby joint, opening a small passageway for the nerve, and/or removing a herniated disc. The procedure can be done through a small incision or with a special scope.
This code encompasses laminotomy (hemilaminectomy), a partial laminectomy involving the removal of upper and lower portions of adjacent laminae (on either side of a vertebral interspace), not the entire lamina of a single vertebra.The procedure includes decompression of the nerve root(s) and may involve a partial facetectomy, foraminotomy, and/or excision of a herniated intervertebral disc.Both open and endoscopic approaches are included.For bilateral procedures, report 63020 with modifier 50.Additional cervical interspaces treated beyond the first require the addition of code 63035.
Example 1: A 45-year-old presents with cervical radiculopathy due to a herniated disc at C5-C6.A laminotomy at C5-C6 is performed to decompress the nerve root., A 60-year-old with cervical spinal stenosis undergoes a laminotomy at C4-C5 and C5-C6 with foraminotomy to alleviate nerve root compression., A 30-year-old sustains a cervical fracture with spinal cord compression.A laminotomy is performed to decompress the spinal cord.
Detailed history and physical examination, pre-operative imaging studies (MRI, CT), operative report clearly documenting the approach (open or endoscopic), levels treated, structures addressed (facetectomy, foraminotomy, discectomy), and post-operative imaging studies as deemed necessary.
** Careful documentation is crucial for accurate coding and reimbursement.Any discrepancies between the operative report and the billing should be addressed immediately.
- Revenue Code: P1F (Major Procedure - Exploration/Decompression/Excision Disc)
- RVU: Relative Value Units (RVUs) vary based on geographic location and payer. Consult the appropriate fee schedule for specific values.
- Global Days: The global period for this procedure depends on the payer and may vary.Consult the specific payer's guidelines for details.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code because it represents a complete surgical procedure.
- Fee Schedule: Historical fee schedules vary widely depending on the payer and geographic location.Consult historical fee schedules for specific details.
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Hospital Outpatient