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The CPT® Code 63744 refers to the procedure involving the replacement, irrigation, or revision of a lumbosubarachnoid shunt. A lumbar subarachnoid shunt is a medical device used to manage cerebrospinal fluid (CSF) flow in patients with conditions that may lead to increased intracranial pressure or other complications. When a shunt becomes obstructed, infected, or experiences other complications, it may necessitate intervention. This procedure can involve replacing the existing shunt with a new one, irrigating the shunt to clear any blockages, or revising the shunt by replacing a segment of the catheter. The process begins with an incision over the lumbar spine, allowing access to the shunt. The existing catheter is manipulated using a guidewire to facilitate the replacement or revision. In cases where irrigation is required, sterile saline is used to flush the shunt to restore its function. This code does not cover the complete removal of the shunt system, which is designated by a different code (CPT® 63746). The procedure is critical for maintaining proper CSF flow and preventing further complications associated with shunt malfunction.
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The procedure associated with CPT® Code 63744 is indicated for the following conditions:
The procedure for CPT® Code 63744 involves several critical steps to ensure the effective replacement, irrigation, or revision of the lumbosubarachnoid shunt:
After the completion of the procedure, appropriate post-procedure care is essential to ensure recovery and monitor for any complications. The incision site is typically closed with sutures or adhesive strips, and the patient may be monitored for signs of infection or shunt malfunction. Follow-up appointments are often scheduled to assess the function of the new or revised shunt and to ensure that cerebrospinal fluid flow is adequately restored. Patients may also receive instructions regarding activity restrictions and signs to watch for that may indicate complications.
| Short Descr | REVISION OF SPINAL SHUNT | Medium Descr | RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT | Long Descr | Replacement, irrigation or revision of lumbosubarachnoid shunt | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | 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). | 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.) | 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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| Pre-1990 | Added | Code added. |
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