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The procedure described by CPT® Code 63066 refers to a surgical intervention performed via a costovertebral approach, specifically targeting the thoracic region of the spine. This approach is utilized for the decompression of the spinal cord or nerve roots, particularly in cases involving conditions such as herniated intervertebral discs. The term 'costovertebral' indicates that the surgery involves both the vertebrae and the ribs, as the procedure necessitates partial excision of a rib and removal of the transverse process on the affected side. This surgical technique allows for the creation of a ventral window, which is essential for visualizing and accessing the spinal cord and nerve roots during the operation. The transverse processes, which are bony projections extending laterally from the vertebrae, play a crucial role in this procedure. In the thoracic spine, these processes are notably longer and more robust than in other spinal regions, and they articulate with the ribs. The surgical process begins with a semilunar skin incision made over the thoracic spine, which is then extended to expose the posterior aspect of the rib. Following this, the surrounding soft tissue and muscles are carefully dissected to reveal the rib and transverse process. The surgical team elevates the paraspinal muscles to access the spinous process, lamina, and transverse process, allowing for the necessary exposure of the lamina and facet joint. Once the area is adequately exposed, a high-speed drill is employed to remove a portion of the rib and transverse process, thereby creating a window through which the spinal cord and nerve roots can be accessed. The procedure involves careful examination of the intervertebral disc, where any herniation is identified. The surgeon will excise bone spurs and create a cavity to facilitate the removal of any ruptured disc fragments or bulging nucleus pulposus that may be compressing the spinal cord or nerve roots. Additional bone may be removed as required to alleviate pressure on the affected nerves. After ensuring that any bleeding is controlled, the surgical wound is meticulously closed in layers. This code is specifically used for each additional thoracic vertebral segment involved in the procedure, following the primary procedure code.
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The indications for performing the procedure associated with CPT® Code 63066 include the following conditions:
The procedure involves several critical steps to ensure effective decompression of the spinal cord or nerve roots:
Post-procedure care following the decompression surgery includes monitoring for any complications, managing pain, and ensuring proper recovery. Patients may be advised to limit physical activity and follow specific rehabilitation protocols to facilitate healing. Follow-up appointments are essential to assess the surgical site and the patient's recovery progress. Any signs of infection, increased pain, or neurological deficits should be reported to the healthcare provider immediately for further evaluation and management.
| Short Descr | DECOMPRESS SPINE CORD ADD-ON | Medium Descr | COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG | Long Descr | Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary procedure) | Status Code | Active 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | 1 | 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.
| 63064 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment |
| 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. | 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). | 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 |
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| 2008-01-01 | Changed | Code description changed. |
| 2007-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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