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The CPT® Code 63043 refers to a surgical procedure known as laminotomy, specifically a hemilaminectomy, which is performed to relieve pressure on nerve roots in the cervical spine. This procedure is typically indicated for patients who have previously undergone surgery in the cervical region and require re-exploration due to persistent symptoms or complications. The term 'laminotomy' refers to the surgical removal of a portion of the lamina, which is the bony arch of the vertebra that covers the spinal canal. A hemilaminectomy involves removing a section of the lamina on one side of the vertebra, allowing access to the spinal canal and nerve roots. During the procedure, the surgeon may also perform a partial facetectomy, which involves the removal of a portion of the facet joint, and a foraminotomy, which is the enlargement of the foramen—the opening through which nerve roots exit the spinal column. Additionally, if a herniated intervertebral disc is present, the surgeon may excise the herniated disc material to decompress the affected nerve root. The procedure is performed through a previously made incision, which is reopened to access the cervical disc space. The surgeon carefully removes any scar tissue that may have formed since the initial surgery, allowing for better visualization and access to the nerve roots. The goal of this procedure is to alleviate pain and restore function by relieving pressure on the nerve roots, thereby addressing the underlying issues that may have led to the need for re-exploration.
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The procedure described by CPT® Code 63043 is indicated for patients experiencing symptoms related to nerve root compression in the cervical spine. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 63043 involves several critical steps to ensure effective decompression of the nerve roots. The following outlines the procedural steps:
After the completion of the laminotomy procedure, patients can expect a recovery period that may involve monitoring for any complications, managing pain, and following specific post-operative care instructions. It is essential for patients to adhere to their surgeon's recommendations regarding activity restrictions, physical therapy, and follow-up appointments to ensure optimal healing and recovery. The expected recovery time may vary based on individual circumstances, including the extent of the surgery and the patient's overall health. Regular follow-up visits will help assess the success of the procedure and address any ongoing symptoms or concerns.
| Short Descr | LAMINOTOMY ADDL CERVICAL | Medium Descr | LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV | Long Descr | Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (List separately in addition to code for primary procedure) | Status Code | Carriers Price the Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1F - Major procedure - explor/decompr/excis disc | MUE | 4 | CCS Clinical Classification | 3 - Laminectomy, excision intervertebral disc |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 63040 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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