How To Use CPT Code 63090

CPT 63090 describes the procedure of vertebral corpectomy, which involves the excision of a lower thoracic, lumbar, or sacral vertebral segment. 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 63090?

CPT 63090 is a code used to describe the surgical procedure known as vertebral corpectomy. This procedure involves the removal of all or part of a lower thoracic, lumbar, or sacral vertebral segment. It is performed via a transperitoneal or retroperitoneal approach, and includes decompression of the spinal cord, cauda equina, and/or nerve roots at a single level.

2. Official Description

The official description of CPT code 63090 is: ‘Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment.’

3. Procedure

1. The surgeon begins by making an incision and accessing the affected area through either a transperitoneal (abdominal) or retroperitoneal (anterolateral) approach.
2. The diseased or damaged part of the vertebral bone is then excised, relieving pressure on the spinal cord.
3. The discs above and below the excised vertebrae may also be removed.
4. Bolts are inserted above and below the vertebrae to provide stability.
5. A bone graft is inserted into the vertebral gap to promote fusion.
6. A metal plate may be used to close the vertebral gap and provide additional support.

4. Qualifying circumstances

CPT 63090 is typically performed on patients who require decompression of the spinal cord, cauda equina, or nerve roots due to a lower thoracic, lumbar, or sacral vertebral condition. The procedure is performed by a qualified surgeon and may be necessary for conditions such as fractures, tumors, infections, or degenerative diseases affecting the spine.

5. When to use CPT code 63090

CPT code 63090 should be used when a surgeon performs a vertebral corpectomy procedure on a single segment of the lower thoracic, lumbar, or sacral spine. It is important to accurately document the specific level and extent of the corpectomy in order to report this code correctly.

6. Documentation requirements

To support a claim for CPT 63090, the surgeon must document the following information:

• The specific vertebral segment(s) involved in the corpectomy
• The approach used (transperitoneal or retroperitoneal)
• The decompression performed on the spinal cord, cauda equina, and/or nerve roots
• Any additional procedures performed, such as disc removal or fusion
• Any complications or unexpected findings during the procedure
• The surgeon’s signature and credentials

7. Billing guidelines

When billing for CPT 63090, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The surgeon should be qualified to perform the procedure and the documentation should support the medical necessity of the corpectomy and decompression. It is also important to follow any additional guidelines or requirements set forth by the payer or insurance company.

8. Historical information

CPT code 63090 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare billing purposes.

9. Examples

1. A patient with a lumbar vertebral fracture undergoes a vertebral corpectomy at the L4 level to relieve pressure on the spinal cord.
2. A tumor in the lower thoracic spine necessitates a vertebral corpectomy at the T9 level, with decompression of the nerve roots.
3. A patient with a degenerative disc disease in the sacral spine undergoes a vertebral corpectomy at the S1 level, with decompression of the cauda equina.
4. A patient with an infection in the lumbar spine requires a vertebral corpectomy at the L3 level, with decompression of the spinal cord.
5. A traumatic injury to the lower thoracic spine leads to a vertebral corpectomy at the T12 level, with decompression of the nerve roots.
6. A patient with a tumor in the sacral spine undergoes a vertebral corpectomy at the S2 level, with decompression of the cauda equina.
7. A degenerative disease affecting the lumbar spine necessitates a vertebral corpectomy at the L5 level, with decompression of the spinal cord.
8. A patient with a herniated disc in the lower thoracic spine requires a vertebral corpectomy at the T11 level, with decompression of the nerve roots.
9. An infection in the sacral spine leads to a vertebral corpectomy at the S3 level, with decompression of the cauda equina.
10. A patient with a tumor in the lumbar spine undergoes a vertebral corpectomy at the L2 level, with decompression of the spinal cord.