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A meningocele is a specific type of spina bifida, which is classified as a congenital anomaly resulting from improper closure of the neural tube during the early stages of fetal development, typically within the first month. In cases of meningocele, the spinal cord itself develops normally; however, there is a protrusion of the meninges, which are the protective membranes surrounding the spinal cord, through a defect in the vertebral column. This condition may present with a thin membrane covering the protruding meninges. The surgical procedure associated with CPT® Code 63700 involves the repair of a meningocele that is less than 5 cm in diameter. During the procedure, a surgical incision is made in the membrane (sac) that covers the meninges, allowing for the drainage of any excess cerebrospinal fluid that may be present. Following this, the skin is meticulously closed in layers over the protruding meninges to ensure proper healing and protection. In instances where direct closure of the skin is not feasible, a skin flap may be created from adjacent skin, typically from the back or buttocks. This flap is then rotated to adequately cover the defect and is sutured securely to the surrounding tissue. It is important to note that if the meningocele defect measures 5 cm or larger, CPT® Code 63702 should be utilized instead of 63700.
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The procedure associated with CPT® Code 63700 is indicated for the surgical repair of a meningocele that is less than 5 cm in diameter. The following conditions may warrant this surgical intervention:
The surgical procedure for the repair of a meningocele involves several critical steps, which are outlined as follows:
Post-procedure care following the repair of a meningocele includes monitoring for any signs of infection, ensuring proper wound healing, and managing pain as necessary. Patients may require follow-up appointments to assess the surgical site and overall recovery. It is also important to provide education on activity restrictions and signs of complications that should prompt immediate medical attention. The expected recovery time may vary based on individual circumstances, but careful adherence to post-operative instructions is essential for optimal outcomes.
| Short Descr | REPAIR OF SPINAL HERNIATION | Medium Descr | REPAIR MENINGOCELE < 5 CM DIAMETER | Long Descr | Repair of meningocele; less than 5 cm diameter | 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 |
| 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). | 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. | 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.) | 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 |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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