0 code page views remaining today. Guest accounts are limited to 2 daily page views. Register free account to get more views.
Log in Register free account

Official Description

Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 63270 involves a laminectomy specifically for the excision of an intraspinal lesion that is classified as non-neoplastic and located intradurally within the cervical region. Non-neoplastic intraspinal lesions can arise from various causes, including infectious agents such as tuberculosis, syphilis, cytomegalovirus, herpes simplex virus, bacteria, or parasites. Additionally, non-infectious lesions may be attributed to conditions like sarcoidosis, multiple sclerosis, or systemic lupus erythematosus. Inflammatory lesions, which can result from idiopathic necrotizing processes or radiation myelopathy, also fall under this category. The laminectomy procedure entails making an incision in the skin over the affected cervical area, extending down to the spinous processes, and retracting the muscle to access the lamina and facet joint. A bone drill is utilized to remove part or all of the lamina, allowing for exposure of the spinal cord. The surgeon then identifies the lesion within the dura mater, incises the dura over the lesion, and explores the extent of the lesion. A tissue sample may be collected for pathology examination to determine the nature of the lesion. Once identified, the lesion is meticulously dissected from surrounding tissues using an operating microscope and is removed once it is completely free. This procedure is critical for addressing non-neoplastic lesions that may cause neurological symptoms or complications due to their location within the spinal canal.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The laminectomy for excision of an intraspinal lesion other than neoplasm, intradural, is indicated for various conditions that involve non-neoplastic lesions within the spinal canal. These indications include:

  • Infectious Lesions These may include lesions caused by infectious agents such as tuberculosis, syphilis, cytomegalovirus, herpes simplex virus, bacteria, or parasites.
  • Non-Infectious Lesions Conditions such as sarcoidosis, multiple sclerosis, or systemic lupus erythematosus can lead to the formation of non-infectious intraspinal lesions.
  • Inflammatory Lesions These lesions may arise from idiopathic necrotizing processes or radiation myelopathy, necessitating surgical intervention.

2. Procedure

The procedure for CPT® Code 63270 involves several critical steps to ensure the safe and effective excision of the intraspinal lesion:

  • Step 1: Incision The procedure begins with an incision made in the skin over the cervical region where the intraspinal lesion is located. This incision is extended down to the spinous processes to provide adequate access to the underlying structures.
  • Step 2: Muscle Retraction Once the incision is made, the muscle is carefully retracted off the lamina and facet joint to expose the bony structures of the spine.
  • Step 3: Bone Removal A bone drill is then utilized to remove part or all of the lamina, which is the bony arch of the vertebra. This step is crucial for exposing the spinal cord and the dura mater that encases it.
  • Step 4: Dura Mater Incision After the lamina is removed, the spinal cord is exposed, and the surgeon identifies the lesion within the dura mater. The dura is incised over the site of the lesion to allow for direct access.
  • Step 5: Lesion Exploration The extent of the lesion is explored to assess its size and relationship to surrounding tissues. This exploration may involve obtaining a tissue sample for pathology examination.
  • Step 6: Lesion Dissection and Removal Once the nature of the lesion is determined, it is carefully dissected away from the surrounding tissue using an operating microscope. This meticulous dissection ensures that the lesion is completely free of all surrounding tissue before removal.

3. Post-Procedure

Post-procedure care following a laminectomy for excision of an intraspinal lesion typically involves monitoring the patient for any complications related to the surgery. Patients may experience pain at the incision site, which can be managed with appropriate analgesics. Rehabilitation may be necessary to restore function and mobility, depending on the extent of the surgery and the patient's overall health. Follow-up appointments are essential to assess the surgical site, review pathology results, and monitor for any recurrence of symptoms. Additional considerations may include physical therapy to aid in recovery and prevent complications such as stiffness or weakness.

Short Descr EXCISE INTRSPINL LESION CRVL
Medium Descr LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL
Long Descr Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard 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 Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures

This is a primary code that can be used with these additional add-on codes.

22840 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)
22841 Addon Code MPFS Status: Bundled Code APC C Physician Quality Reporting CPT Assistant Article Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure)
22842 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)
22843 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)
22844 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for primary procedure)
22845 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
22846 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)
22847 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure)
22848 Addon Code MPFS Status: Active Code APC N Physician Quality Reporting CPT Assistant Article Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)
22853 CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)
22854 CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
22859 CPT Add On CPT Resequenced MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
63295 Addon Code MPFS Status: Active Code APC C Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure)
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)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). 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.)
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
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
2013-01-01 Changed Short Descriptor changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description