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The procedure described by CPT® Code 63740 involves the creation of a shunt that facilitates the diversion of cerebrospinal fluid (CSF) from the lumbar subarachnoid space to another body cavity, such as the peritoneal or pleural cavity. This surgical intervention is primarily indicated for the treatment of communicating hydrocephalus, a condition characterized by an accumulation of CSF that can lead to increased intracranial pressure and various neurological symptoms. The procedure begins with a laminectomy, which is a surgical technique that involves the removal of a portion of the vertebral bone (the lamina) to expose the spinal cord and the surrounding structures. Once the spinal cord is accessed, a catheter is placed into the subarachnoid space, allowing for the drainage of CSF. The shunt is then tunneled from the laminectomy site to the designated termination site, ensuring that the CSF can be effectively redirected to alleviate pressure and prevent complications associated with hydrocephalus. This procedure is critical in managing conditions that require the regulation of CSF flow and pressure within the central nervous system.
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The creation of a lumbar subarachnoid shunt, as described by CPT® Code 63740, is indicated for the following conditions:
The procedure for creating a lumbar subarachnoid shunt involves several critical steps to ensure proper placement and function of the shunt:
Post-procedure care following the creation of a lumbar subarachnoid shunt typically involves monitoring for any complications, such as infection or improper catheter placement. Patients may require follow-up imaging to ensure the shunt is functioning correctly and that CSF is being adequately diverted. Recovery may vary based on individual patient factors, but close observation is essential to address any potential issues that may arise after the procedure.
| Short Descr | INSTALL SPINAL SHUNT | Medium Descr | CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM | Long Descr | Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy | 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 | 3 - Laminectomy, excision intervertebral disc |
| 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). | 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. | 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). | 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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| Pre-1990 | Added | Code added. |
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