How To Use CPT Code 0275T

CPT 0275T describes a percutaneous laminotomy/laminectomy procedure that is performed to decompress neural elements in the lumbar region. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0275T?

CPT 0275T is a code used to describe a percutaneous laminotomy/laminectomy procedure that is performed to relieve pressure on the nerve by increasing the space available for the nerve root to exit the spinal canal. This procedure can be used to treat a herniated or bulging disc in the lumbar region. It involves the use of percutaneous techniques under indirect imaging guidance to access and decompress the affected area.

2. Official Description

The official description of CPT code 0275T is: ‘Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), single or multiple levels, unilateral or bilateral; lumbar.’ This code specifically refers to the decompression of neural elements in the lumbar region using percutaneous techniques and indirect image guidance.

3. Procedure

1. The provider begins by making a small incision in the skin of the affected lumbar spinous process.
2. Using imaging guidance, the provider inserts an endoscope and obturator sheath into the incision.
3. The provider advances the obturator through the sheath to reach the interlaminar space or the bony surface, depending on the patient’s anatomy.
4. After confirming the epidural space, the provider drills the center of the superior edge of the lamina under the lesion and dissects the ligamentum flavum.
5. The provider may also perform additional procedures such as ligamentous resection, discectomy, facetectomy, or foraminotomy to decompress the herniated disc(s) at one or multiple levels.
6. If necessary, the provider may repeat the procedure on the opposite side of the vertebra for bilateral cases.
7. Finally, the provider removes all equipment, controls any bleeding, and closes the wound.

4. Qualifying circumstances

CPT 0275T is typically performed on patients with a herniated or bulging disc in the lumbar region. The procedure is used to relieve pressure on the nerve and alleviate pain. It may involve additional procedures such as ligamentous resection, discectomy, facetectomy, or foraminotomy, depending on the specific case. The procedure is performed using percutaneous techniques under indirect image guidance, such as fluoroscopy or CT.

5. When to use CPT code 0275T

CPT code 0275T should be used when a percutaneous laminotomy/laminectomy procedure is performed to decompress neural elements in the lumbar region. This code is appropriate for single or multiple levels, unilateral or bilateral cases. It is important to ensure that the procedure is performed using percutaneous techniques and under indirect image guidance. If the procedure is performed on the cervical or thoracic spine, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 0275T, the provider must document the following information:

• Patient’s diagnosis and the need for decompression of neural elements in the lumbar region
• Specific percutaneous techniques used during the procedure
• Date and details of the procedure, including the number of levels treated and whether it was performed unilaterally or bilaterally
• Any additional procedures performed, such as ligamentous resection, discectomy, facetectomy, or foraminotomy
• Confirmation of the epidural space and the decompression of the herniated disc(s)
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 0275T, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure should be performed using percutaneous techniques and under indirect image guidance. It is also important to indicate the number of levels treated and whether the procedure was performed unilaterally or bilaterally. Additionally, it is important to follow any specific guidelines provided by the payer regarding the coverage and reimbursement of this procedure.

8. Historical information

CPT code 0275T was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A patient with a herniated disc in the lumbar region undergoes a percutaneous laminotomy/laminectomy procedure to decompress the neural elements.
2. A provider performs a percutaneous laminotomy/laminectomy procedure on a patient with a bulging disc at multiple levels in the lumbar region.
3. A patient with severe pain due to a herniated disc undergoes a percutaneous laminotomy/laminectomy procedure to relieve pressure on the nerve.
4. A provider performs a percutaneous laminotomy/laminectomy procedure on a patient with a herniated disc at a single level in the lumbar region.
5. A patient with bilateral herniated discs in the lumbar region undergoes a percutaneous laminotomy/laminectomy procedure on both sides.
6. A provider performs a percutaneous laminotomy/laminectomy procedure on a patient with a herniated disc and performs additional procedures such as ligamentous resection and foraminotomy.
7. A patient with chronic back pain undergoes a percutaneous laminotomy/laminectomy procedure to decompress the neural elements in the lumbar region.
8. A provider performs a percutaneous laminotomy/laminectomy procedure on a patient with a herniated disc and performs additional procedures such as discectomy and facetectomy.
9. A patient with radiating leg pain due to a herniated disc undergoes a percutaneous laminotomy/laminectomy procedure to relieve pressure on the nerve.
10. A provider performs a percutaneous laminotomy/laminectomy procedure on a patient with a herniated disc and performs additional procedures such as ligamentous resection and facetectomy.