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Stereotactic radiosurgery (SRS) is a non-invasive medical procedure that utilizes advanced technology to deliver a concentrated dose of radiation to a specific area within the body, particularly targeting spinal lesions. This procedure is performed on a single spinal lesion and employs various forms of radiation delivery systems, including particle beams, gamma rays, or linear accelerators (LINAC). The primary goal of stereotactic radiosurgery is to precisely target and treat tumors or lesions while minimizing exposure to surrounding healthy tissues. The technique involves the use of multiple intersecting beams of radiation that converge on the lesion, allowing for a high dose of radiation to be administered in a single session. Particle beam technology, although less commonly used in the United States, is one method of delivering this treatment. Gamma ray technology, often referred to as gamma knife surgery, utilizes a specialized device that focuses 201 beams of gamma rays on the lesion, making it particularly effective for small to medium-sized tumors. On the other hand, linear accelerators generate high-energy X-ray photons or electrons, which can be manipulated to treat larger lesions through curving paths. Prior to the actual treatment, a planning procedure is conducted, which is separately reportable. This involves imaging techniques such as three-dimensional MRI or CT scans to visualize the lesion accurately. For spinal lesions, a frameless technique is typically employed to enhance precision. Depending on the location of the lesion, different stabilization methods are used; for cervical spine lesions, a molded face mask may be utilized, while for thoracic or lumbar spine lesions, gold fiducial markers are implanted to aid in directing the radiation beams. The treatment plan includes determining the lesion's location and volume, assessing surrounding structures to evaluate potential risks, and calculating the appropriate radiation dose. The procedure is designed to ensure that the radiation is delivered accurately and effectively to achieve the desired therapeutic outcome.
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The procedure of stereotactic radiosurgery (CPT® Code 63620) is indicated for the treatment of specific spinal lesions. The following conditions may warrant the use of this procedure:
The procedure for stereotactic radiosurgery involves several critical steps to ensure accurate treatment of the spinal lesion:
After the completion of the stereotactic radiosurgery procedure, patients may be monitored for any immediate side effects or complications. The recovery process typically involves minimal downtime, as the procedure is non-invasive. Patients are usually advised to follow up with their healthcare provider to assess the effectiveness of the treatment and to monitor for any potential side effects. It is essential to evaluate the lesion's response to the radiation over time, which may involve additional imaging studies. Patients should also be informed about any signs or symptoms to watch for that may indicate complications or the need for further medical attention.
| Short Descr | SRS SPINAL LESION | Medium Descr | STEREOTACTIC RADIOSURGERY 1 SPINAL LESION | Long Descr | Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 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 | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | 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.
| 63621 | Addon Code MPFS Status: Active Code APC B Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (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. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | 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.) | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2011-01-01 | Changed | Short description changed. |
| 2009-01-01 | Added | - |
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