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The CPT® Code 63600 refers to the creation of a lesion on the spinal cord using a stereotactic method, which is a precise technique that employs advanced imaging technology to guide surgical instruments. This procedure is performed percutaneously, meaning it is done through the skin with minimal incisions. The stereotactic approach utilizes three-dimensional imaging, often obtained through computed tomography (CT) or magnetic resonance imaging (MRI), to accurately locate abnormalities within the spinal cord. By generating a detailed 3-D representation of the spine, surgeons can determine the safest and most direct route to the targeted area requiring intervention. During the procedure, a small incision is made over the spine, and specialized instruments are navigated towards the abnormality using a surgical navigation system that tracks the instruments in real-time. The primary goal of this procedure is to create a lesion that blocks the transmission of pain signals to the brain, thereby alleviating pain for the patient. To achieve this, electrodes are strategically placed along the spinal cord and connected to a generator that produces electrical impulses. These impulses stimulate the spinal cord, and recordings may be taken as necessary to assess the effectiveness of the stimulation. The optimal site for the lesion is carefully identified, and a thermal, electrical, or radiofrequency device is then advanced to this location to destroy the targeted spinal cord region, effectively creating the lesion. This procedure is distinct from other related procedures, such as CPT® Code 63610, which involves percutaneous stereotactic stimulation of the spinal cord without creating a lesion.
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The procedure described by CPT® Code 63600 is indicated for patients experiencing chronic pain conditions that may be alleviated through the creation of a lesion on the spinal cord. This may include, but is not limited to, the following conditions:
The procedure involves several critical steps to ensure precision and effectiveness in creating a lesion on the spinal cord:
Following the procedure, patients may require monitoring for any immediate complications or side effects. Post-procedure care typically includes pain management and observation to assess the effectiveness of the lesion in alleviating pain. Patients may also be advised on activity restrictions and follow-up appointments to evaluate recovery and the overall success of the procedure. It is essential for healthcare providers to document the outcomes and any recordings obtained during the procedure for future reference and treatment planning.
| Short Descr | REMOVE SPINAL CORD LESION | Medium Descr | CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ | Long Descr | Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) | 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) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 2 | CCS Clinical Classification | 5 - Insertion of catheter or spinal stimulator and injection into spinal canal |
| 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) |
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| Pre-1990 | Added | Code added. |
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