How To Use CPT Code 63005

CPT 63005 describes the procedure of laminectomy with exploration and/or decompression of the spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy, specifically in the lumbar region. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 63005?

CPT 63005 is used to describe a specific surgical procedure known as laminectomy. This procedure involves the removal of the spinous process and one or both laminae of one or two lumbar vertebral segments. The purpose of the procedure is to explore and/or decompress the spinal cord and/or cauda equina. It is important to note that this procedure does not include facetectomy, foraminotomy, or discectomy.

2. Official Description

The official description of CPT code 63005 is: ‘Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis.’

3. Procedure

1. During a laminectomy, the surgeon removes the spinous process and one or both laminae of one or two lumbar vertebral segments.
2. The purpose of the procedure is to explore and/or decompress the spinal cord and/or cauda equina.
3. The surgeon may perform a laminectomy on several adjacent vertebral levels depending on the condition of the patient.

4. Qualifying circumstances

CPT 63005 is typically performed on patients with spinal stenosis, a condition characterized by the narrowing of the spinal canal. It is important to note that this procedure is specifically for the lumbar region and should not be used for spondylolisthesis, a condition where one vertebra slips forward onto the vertebra below it.

5. When to use CPT code 63005

CPT code 63005 should be used when a laminectomy is performed on one or two lumbar vertebral segments without the inclusion of facetectomy, foraminotomy, or discectomy. It is important to accurately document the specific procedure performed to ensure proper coding.

6. Documentation requirements

To support a claim for CPT 63005, the following documentation is required:

• Specific details of the laminectomy procedure performed
• Documentation of the exploration and/or decompression of the spinal cord and/or cauda equina
• Identification of the lumbar vertebral segments involved
• Any additional procedures performed, such as facetectomy, foraminotomy, or discectomy, if applicable
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 63005, it is important to accurately report the procedure performed. This code should not be reported with other codes for facetectomy, foraminotomy, or discectomy. It is important to follow the specific guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT 63005 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a laminectomy with exploration and decompression of the spinal cord and cauda equina in the lumbar region to treat spinal stenosis.
2. A surgeon performs a laminectomy on two lumbar vertebral segments without facetectomy, foraminotomy, or discectomy to relieve pressure on the spinal cord and cauda equina.
3. A patient with spinal stenosis undergoes a laminectomy on one lumbar vertebral segment to alleviate symptoms and improve mobility.
4. A surgeon performs a laminectomy on two adjacent lumbar vertebral segments to decompress the spinal cord and cauda equina and address symptoms of spinal stenosis.
5. A patient with spinal stenosis undergoes a laminectomy on one lumbar vertebral segment to relieve pressure on the spinal cord and cauda equina and improve overall function.
6. A surgeon performs a laminectomy on two lumbar vertebral segments without facetectomy, foraminotomy, or discectomy to address symptoms of spinal stenosis and improve the patient’s quality of life.
7. A patient undergoes a laminectomy with exploration and decompression of the spinal cord and cauda equina in the lumbar region to alleviate symptoms of spinal stenosis and improve mobility.
8. A surgeon performs a laminectomy on one lumbar vertebral segment without facetectomy, foraminotomy, or discectomy to relieve pressure on the spinal cord and cauda equina and improve overall function.
9. A patient with spinal stenosis undergoes a laminectomy on two adjacent lumbar vertebral segments to decompress the spinal cord and cauda equina and address symptoms of spinal stenosis.