CPT Code 63035 | Description & Clinical Information
CPT 63035 describes the surgical procedure of laminotomy for each additional cervical or lumbar interspace, which involves decompression of the nerve root(s) and may include partial facetectomy, foraminotomy, and/or excision of a herniated intervertebral disc, and can be performed using either open or endoscopic approaches.
Official Description
The CPT book defines CPT code 63035 as: “Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (List separately in addition to code for primary procedure)”.
Billing Guidelines
Use CPT code 63035 in combination with CPT codes 63020 through 63030.
Do not use codes 63030 and 63035 with codes 22630, 22632, 22633, and 22634 when performing laminotomy to prepare the interspace for fusion on the same vertebral segment and interspace. Use of these codes together is not recommended.
If a laminectomy, removal of facets, and/or opening/widening of the foramen is performed for decompression of nerves or spinal components on the same interspace[s] and vertebral segment[s] as posterior interbody fusion, then refer to CPT codes 63052 and 63053.
Report CPT code 63035 twice for a bilateral procedure. It is not necessary to use modifier 50 with CPT code 63035.
To access the percutaneous endoscopic approach, refer to CPT codes 0274T and 0275T.
Clinical Information
The procedure described by CPT code 63035 is known as a laminotomy. This is a type of spinal surgery that involves removing the upper and lower portions of adjacent laminae, rather than removing the entire lamina(ae) of a single vertebra. This procedure is also sometimes referred to as hemilaminectomy or partial laminectomy.
During a laminotomy, the surgeon removes the upper and lower portions of the laminae surrounding two adjacent vertebral interspaces. If the surgeon performs two hemilaminectomies at adjacent levels, they may choose to remove the entire lamina. This may look like a complete laminectomy, but the procedure still qualifies as two hemilaminectomies as long as the surgeon excises the intervertebral discs as well.
It is important to report an initial laminotomy using either 63020 (for cervical procedures) or 63030 (for lumbar procedures), and to use +63035 for each additional cervical or lumbar level the provider treats beyond the first. This ensures that the procedure is accurately coded and billed to the patient’s insurance provider.
If the provider performs the procedure bilaterally, it may be appropriate to append modifier 50 to the laminotomy code. However, it is important to check with the payer to ensure that this is acceptable. In some cases, it may be necessary to report the code twice instead of using the modifier.
Laminotomy is a common procedure used to treat a variety of spinal conditions, including spinal stenosis and herniated discs. It can help to relieve pressure on the nerves in the spinal cord and improve overall mobility and quality of life for the patient.
As with any surgical procedure, there are risks associated with laminotomy. These may include bleeding, infection, and damage to surrounding tissues and nerves. Patients should be fully informed of the risks and benefits of the procedure before making a decision to undergo surgery.
Overall, laminotomy is a valuable tool in the treatment of spinal conditions. By accurately coding and billing for this procedure, healthcare providers can help to ensure that patients receive the care they need while also minimizing administrative complications and costs.
