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Osteoplastic reconstruction of dorsal spinal elements refers to a surgical procedure aimed at restoring the structural integrity of the spine after a primary intraspinal procedure, such as a laminectomy. This reconstruction is particularly significant in pediatric patients, who are more susceptible to developing kyphotic spinal deformities following such procedures. The term "osteoplastic" indicates that the procedure involves the manipulation and reconstruction of bone structures. During this operation, the dorsal elements of the spine, which may include the laminae, spinous processes, and associated ligaments, are meticulously repositioned to their original anatomical locations. The process typically involves the use of a drill to prepare these structures for the application of internal fixation devices. These devices, which can include heavy sutures, wires, or mini-plates, are employed to secure the reconstructed elements firmly in place, ensuring stability and proper alignment of the spine post-surgery. This procedure is coded separately from the primary intraspinal procedure, highlighting its role as an adjunctive surgical intervention aimed at enhancing patient outcomes and preventing complications related to spinal deformities.
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Osteoplastic reconstruction of dorsal spinal elements is indicated in specific scenarios following primary intraspinal procedures. The primary indications include:
The procedure for osteoplastic reconstruction of dorsal spinal elements involves several critical steps, which are detailed as follows:
After the osteoplastic reconstruction procedure, patients typically require careful monitoring and follow-up care to ensure proper healing and alignment of the spine. Post-procedure care may include pain management, physical therapy, and regular imaging studies to assess the stability of the reconstructed elements. The expected recovery period can vary based on the individual patient's condition and the extent of the reconstruction performed. It is essential for healthcare providers to provide clear instructions regarding activity restrictions and rehabilitation to optimize recovery outcomes.
| Short Descr | REPAIR LAMINECTOMY DEFECT | Medium Descr | OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX | Long Descr | Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (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) | 2 - 150% payment adjustment 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) | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 63172 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space | 63173 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space | 63185 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with rhizotomy; 1 or 2 segments | 63190 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with rhizotomy; more than 2 segments | 63200 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy, with release of tethered spinal cord, lumbar | 63250 | MPFS Status: Active Code APC C Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical | 63251 | MPFS Status: Active Code APC C Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic | 63252 | MPFS Status: Active Code APC C Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar | 63265 | MPFS Status: Active Code APC J1 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical | 63266 | MPFS Status: Active Code APC J1 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic | 63267 | MPFS Status: Active Code APC J1 Physician Quality Reporting Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar | 63268 | MPFS Status: Active Code APC J1 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral | 63270 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical | 63271 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic | 63272 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar | 63273 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral | 63275 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical | 63276 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic | 63277 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar | 63278 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral | 63280 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical | 63281 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic | 63282 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar | 63283 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral | 63285 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical | 63286 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic | 63287 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar | 63290 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level | 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. | 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. | 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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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2005-01-01 | Added | First appearance in code book in 2005. |