How To Use CPT Code 63077

CPT 63077 describes the procedure for anterior discectomy with decompression of the spinal cord and/or nerve root(s) in the thoracic 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 63077?

CPT 63077 is used to describe a surgical procedure that involves the removal of a herniated thoracic disc and decompression of the spinal cord and/or nerve root(s). The provider repairs the herniated disc by removing all or a portion of it and uses grafts to fill the empty space. This procedure is performed to alleviate pain and inflammation caused by the herniation and to restore proper function to the affected area.

2. Official Description

The official description of CPT code 63077 is: ‘Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace.’

3. Procedure

1. The provider makes an incision through the chest cavity or approaches the herniated disc from behind and to the side.
2. If using an anterior transthoracic approach, the provider makes an incision that crosses the thoracic spine and carefully opens the area into the thoracic cavity.
3. If using a posterolateral approach, the provider makes an incision about two ribs higher than the level of the herniated disc and performs a rib dissection.
4. The provider retracts the lung and other internal structures as necessary to reach the spinal cord.
5. Using an operating microscope for additional visualization, the provider removes portions of the vertebrae adjacent to the disc and removes the herniated disc material to decompress the spinal cord or nerve roots.
6. The provider prepares the vertebral bodies to accept harvested rib bone, places sections of the bone into the disc space, and sutures them together.
7. The provider releases the retracted structures into place, may insert a chest drain, and performs layered closure and applies sterile dressings.

4. Qualifying circumstances

CPT 63077 is performed on patients with a herniated thoracic disc that causes pain, inflammation, and potential myelopathy. The procedure is indicated when conservative treatments have failed to alleviate symptoms, and surgical intervention is necessary. The provider must carefully assess the patient’s condition and determine the need for decompression of the spinal cord and/or nerve root(s) before performing the procedure.

5. When to use CPT code 63077

CPT code 63077 should be used when the provider performs an anterior discectomy with decompression of the spinal cord and/or nerve root(s) in the thoracic region. It is important to ensure that the procedure is performed on a single interspace in the thoracic spine. If additional thoracic interspaces are involved, report CPT code 63078 for each additional interspace.

6. Documentation requirements

To support a claim for CPT 63077, the provider must document the following information:

• Patient’s diagnosis and the need for anterior discectomy with decompression
• Specific details of the procedure, including the approach used and the level of the thoracic spine
• Date of the procedure
• Any additional procedures performed, such as osteophytectomy
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 63077, ensure that the procedure is performed on a single interspace in the thoracic spine. If additional interspaces are involved, report CPT code 63078 for each additional interspace. It is important to follow the specific guidelines provided by the payer and to use the appropriate modifiers if required. It is also important to ensure accurate and detailed documentation to support the billing of CPT 63077.

8. Historical information

CPT 63077 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. However, it is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A patient undergoes anterior discectomy with decompression of the spinal cord and nerve root(s) at the T6-T7 interspace to alleviate pain and inflammation caused by a herniated thoracic disc.
2. A provider performs anterior discectomy with decompression of the spinal cord and nerve root(s) at the T9-T10 interspace to relieve myelopathy symptoms in a patient with a herniated thoracic disc.
3. A surgical team performs anterior discectomy with decompression of the spinal cord and nerve root(s) at the T4-T5 interspace, including osteophytectomy, to address a herniated thoracic disc and remove bone spurs.
4. A patient undergoes anterior discectomy with decompression of the spinal cord and nerve root(s) at the T11-T12 interspace to relieve pain and inflammation caused by a herniated thoracic disc.
5. A provider performs anterior discectomy with decompression of the spinal cord and nerve root(s) at the T7-T8 interspace to alleviate myelopathy symptoms in a patient with a herniated thoracic disc.