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Vertebral corpectomy is a surgical procedure that involves the resection or removal of a 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 or nerve roots. Conditions such as bone spurs, fractures, tumors, or infections affecting the spine may also necessitate this intervention. The procedure is performed using a combined thoracolumbar approach, which allows access to the lower thoracic and lumbar regions of the spine. A co-surgeon team, often consisting of a thoracic surgeon and a spine surgeon, typically collaborates during the operation to ensure optimal exposure and execution of the corpectomy. The surgical approach involves making an incision over the thorax, dissecting the overlying muscles, and potentially resecting one or more ribs to gain adequate access to the thoracic spine. The procedure is intricate and requires careful dissection to remove the intervertebral discs, bone spurs, and any other structures that may be compressing the spinal cord or nerve roots. Following the removal 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:
After the vertebral corpectomy, patients typically require careful monitoring and management of their recovery. Post-procedure care may include pain management, physical therapy, and follow-up imaging to assess the success of the surgery and the integration of the bone graft. Patients may also need to avoid certain activities to promote healing and prevent complications. The placement of a chest tube, if performed, will require monitoring for any signs of complications such as pneumothorax or infection. Overall, the recovery process is individualized based on the extent of the surgery and the patient's overall health status.
| Short Descr | REMOVE VERTEBRAL BODY ADD-ON | Medium Descr | VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG | Long Descr | Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; 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 | 3 | 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.
| 63087 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; 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) |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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. | 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. | 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). | 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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