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Vertebral corpectomy is a surgical procedure that involves the resection of the vertebral body, which is the main part of a vertebra, along with the intervertebral discs located above and below the affected vertebra. This procedure is typically indicated for patients suffering from severe spinal stenosis, which is a narrowing of the spinal canal that can lead to compression of the spinal cord and nerve roots. Conditions such as bone spurs, fractures, tumors, or infections affecting the spine may also necessitate this intervention. The thoracic spine, which is the middle section of the vertebral column, is often the focus of this procedure, and it is performed using a transthoracic approach that requires a thoracotomy, or surgical opening of the chest. This approach allows for adequate access to the thoracic spine, enabling the surgeon to effectively remove the affected vertebral body and decompress the spinal cord and nerve roots. The procedure is complex and typically involves a collaborative effort between a thoracic surgeon, who manages the chest exposure, and a spine surgeon, who performs the corpectomy. The surgical technique requires careful dissection of the overlying muscles and may involve the resection of one or more ribs to facilitate access. The use of a surgical microscope aids in the precise removal of the intervertebral discs and any bone spurs that may be compressing the neural structures. Following the excision of the vertebral body, additional procedures such as bone grafting and fusion may be performed to stabilize the spine and promote healing.
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Vertebral corpectomy is performed for several specific indications, including:
The vertebral corpectomy procedure involves several critical steps, which are detailed as follows:
Post-procedure care following a vertebral corpectomy includes monitoring for complications such as bleeding or infection. Patients may require pain management and physical therapy to aid in recovery. The placement of a chest tube allows for the drainage of any fluid that may accumulate in the thoracic cavity, which is essential for preventing complications such as pneumothorax. The expected recovery period may vary depending on the extent of the surgery and the patient's overall health. Follow-up appointments are crucial to assess the healing process and ensure that the bone graft is integrating properly with the surrounding vertebrae. Patients are typically advised on activity restrictions and rehabilitation protocols to promote optimal recovery.
| Short Descr | REMOVE VERTEBRAL BODY ADD-ON | Medium Descr | VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG | Long Descr | Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); 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) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 2 - Team surgeons permitted; pay by report. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1F - Major procedure - explor/decompr/excis disc | MUE | 2 | 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.
| 63085 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment | 69990 | Addon Code MPFS Status: Restricted APC N ASC N1 PUB 100 CPT Assistant Article 1Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) |
| 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. | 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 | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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