How To Use CPT Code 63170

CPT 63170 describes a surgical procedure known as laminectomy with myelotomy, which is performed to treat chronic severe neuropathic pain that cannot be managed with other therapies. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 63170?

CPT 63170 is a code used to describe a surgical procedure called laminectomy with myelotomy. This procedure is performed to treat chronic severe neuropathic pain that cannot be managed with other therapies. It involves the destruction of the posterolateral portion of the spinal cord, specifically the dorsal nerve roots, to prevent pain signals from passing through the spinal cord to the brain.

2. Official Description

The official description of CPT code 63170 is: ‘Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar.’

3. Procedure

1. Under anesthesia, the physician makes an incision and performs a laminectomy to remove the lamina, a thin plate of bone at the back of a vertebra, to decompress the spinal cord or nerve roots.
2. The laminectomy is extended to the level of the medial facets.
3. The physician identifies the DREZ lesion, which stands for dorsal nerve root entry zone, where the nerve enters the spinal cord.
4. The physician chooses one of the techniques to destroy the nerve root, such as cutting the nerve roots with a surgical blade and coagulating the area with bipolar forceps, using a radiofrequency electrode, using CO2 or argon laser devices, or using focused ultrasound.

4. Qualifying circumstances

CPT 63170 is performed on patients with chronic severe neuropathic pain that cannot be managed with other therapies. The procedure is typically done on the cervical, thoracic, or thoracolumbar regions of the spine. It is important to note that this procedure should only be performed by a qualified physician with the necessary expertise and training.

5. When to use CPT code 63170

CPT code 63170 should be used when a laminectomy with myelotomy procedure is performed to treat chronic severe neuropathic pain that cannot be managed with other therapies. It is important to ensure that the procedure is performed on the appropriate regions of the spine and that the patient meets the qualifying circumstances for this procedure.

6. Documentation requirements

To support a claim for CPT 63170, the physician must document the following information:

• Patient’s diagnosis and the need for the laminectomy with myelotomy procedure
• Details of the procedure performed, including the specific regions of the spine and the technique used to destroy the nerve root
• Date of the procedure
• Any complications or additional procedures performed during the same session
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 63170, it is important to ensure that the procedure is performed by a qualified physician and that the documentation supports the medical necessity of the procedure. It is also important to follow any specific billing guidelines provided by the payer. Additionally, it is important to review any bundling or unbundling rules that may apply to this procedure.

8. Historical information

CPT 63170 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.

9. Examples

1. A patient with chronic severe neuropathic pain in the cervical region undergoes a laminectomy with myelotomy procedure to alleviate their symptoms.
2. A physician performs a laminectomy with myelotomy on a patient with chronic severe neuropathic pain in the thoracic region.
3. A patient with chronic severe neuropathic pain in the thoracolumbar region undergoes a laminectomy with myelotomy procedure to manage their symptoms.
4. A physician performs a laminectomy with myelotomy on a patient with chronic severe neuropathic pain in the cervical, thoracic, and lumbar regions.
5. A patient with chronic severe neuropathic pain in the cervical, thoracic, lumbar, and sacral regions undergoes a laminectomy with myelotomy procedure to alleviate their symptoms.