How To Use CPT Code 63047

CPT 63047 involves a laminectomy, facetectomy, and foraminotomy procedure at a single lumbar vertebral segment to correct spinal stenosis and decompress the spinal cord or nerve roots. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 63047 procedures.

1. What is CPT 63047?

CPT 63047 is a medical procedure code used to describe a specific type of spinal surgery involving a laminectomy, facetectomy, and foraminotomy at a single lumbar vertebral segment. This procedure is performed to correct spinal stenosis and decompress the spinal cord or nerve roots, providing relief to patients suffering from pain, numbness, or weakness due to spinal compression.

2. 63047 CPT code description

The official description of CPT code 63047 is: “Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar.”

3. Procedure

The 63047 procedure involves the following steps:

  1. The patient is appropriately prepped and anesthetized.
  2. The surgeon makes an incision over the affected lumbar vertebra.
  3. The spinous process (the bony projection on the back of the vertebrae) is removed.
  4. One or both lamina (the broad plates of bone on either side of the spinous process that complete the “arch” of the vertebrae and enclose the spinal cord) are removed, performing a laminectomy.
  5. A facetectomy is performed by excising an area of a vertebra characterized by its smooth surface.
  6. A foraminotomy is performed by making an incision into the vertebral opening through which nerve bundles exit out to the body.
  7. The surgeon decompresses the spinal cord, cauda equina, and/or nerve roots by removing any bone, ligament, or disc material causing compression.
  8. Once the stenosis has been relieved, the surgeon closes the incision in layers.

4. Qualifying circumstances

Patients eligible to receive CPT code 63047 services are those who have been diagnosed with spinal stenosis, lateral recess stenosis, or foraminal stenosis in the lumbar region. These conditions may cause pain, numbness, or weakness in the lower back, buttocks, and legs. The patient must have tried conservative treatments, such as physical therapy, medications, or injections, without significant improvement. The surgeon must determine that the patient’s condition warrants surgical intervention to decompress the spinal cord or nerve roots.

5. When to use CPT code 63047

It is appropriate to bill the 63047 CPT code when a provider performs a laminectomy, facetectomy, and foraminotomy at a single lumbar vertebral segment to correct spinal stenosis and decompress the spinal cord or nerve roots. This code should be used for the first spinal level treated, followed by +63048 for each additional level beyond the first. Codes 63045–+63048 apply whether the procedure is unilateral or bilateral.

6. Documentation requirements

To support a claim for CPT 63047, the following information should be documented:

  • Patient’s medical history and physical examination findings
  • Diagnostic imaging studies confirming the presence of spinal stenosis, lateral recess stenosis, or foraminal stenosis in the lumbar region
  • Conservative treatments attempted and their outcomes
  • Surgical plan, including the specific vertebral level(s) to be treated
  • Operative report detailing the procedure performed, including laminectomy, facetectomy, and foraminotomy, as well as any complications encountered
  • Postoperative care plan and follow-up appointments

7. Billing guidelines

When billing for CPT code 63047, it is essential to follow the appropriate guidelines and rules. Use 63047 for the first spinal level treated, followed by +63048 for each additional level beyond the first. Codes 63045–+63048 apply whether the procedure is unilateral or bilateral. Ensure that all required documentation is included in the patient’s medical record to support the claim. Additionally, be aware of any payer-specific requirements or policies related to spinal surgery procedures.

8. Historical information

CPT 63047 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2008, with the previous descriptor being “Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (eg, spinal or lateral recess stenosis)), single vertebral segment; lumbar.”

9. Similar codes to CPT 63047

Five similar codes to CPT 63047 include:

  • CPT 63045: This code is used for cervical or thoracic vertebral segments instead of lumbar.
  • CPT 63046: This code is used for each additional cervical or thoracic vertebral segment beyond the first.
  • CPT 63048: This code is an add-on code used for each additional lumbar vertebral segment beyond the first.
  • CPT 63050: This code is used for a laminoplasty procedure instead of a laminectomy, facetectomy, and foraminotomy.
  • CPT 63056: This code is used for a transpedicular approach to the procedure instead of the standard approach.

10. Examples

Here are 10 detailed examples of CPT code 63047 procedures:

  1. A 45-year-old patient with lumbar spinal stenosis at L4-L5 undergoes a laminectomy, facetectomy, and foraminotomy to decompress the spinal cord and nerve roots.
  2. A 60-year-old patient with foraminal stenosis at L3-L4 undergoes a unilateral foraminotomy, laminectomy, and facetectomy to relieve nerve root compression.
  3. A 55-year-old patient with lateral recess stenosis at L5-S1 undergoes a bilateral laminectomy, facetectomy, and foraminotomy to decompress the spinal cord and nerve roots.
  4. A 50-year-old patient with lumbar spinal stenosis at L2-L3 undergoes a laminectomy, facetectomy, and foraminotomy to alleviate pain and numbness in the lower back and legs.
  5. A 65-year-old patient with foraminal stenosis at L4-L5 undergoes a unilateral foraminotomy, laminectomy, and facetectomy to relieve nerve root compression and improve leg strength.
  6. A 70-year-old patient with lateral recess stenosis at L3-L4 undergoes a bilateral laminectomy, facetectomy, and foraminotomy to decompress the spinal cord and nerve roots.
  7. A 40-year-old patient with lumbar spinal stenosis at L5-S1 undergoes a laminectomy, facetectomy, and foraminotomy to alleviate pain and numbness in the lower back and legs.
  8. A 58-year-old patient with foraminal stenosis at L2-L3 undergoes a unilateral foraminotomy, laminectomy, and facetectomy to relieve nerve root compression and improve leg strength.
  9. A 62-year-old patient with lateral recess stenosis at L4-L5 undergoes a bilateral laminectomy, facetectomy, and foraminotomy to decompress the spinal cord and nerve roots.
  10. A 48-year-old patient with lumbar spinal stenosis at L3-L4 undergoes a laminectomy, facetectomy, and foraminotomy to alleviate pain and numbness in the lower back and legs.

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