How To Use CPT Code 63190

CPT 63190 describes a specific surgical procedure that involves the cutting of nerve roots in the spinal cord to relieve symptoms of neuromuscular conditions. 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 63190?

CPT 63190 is a code used to describe a surgical procedure that involves the cutting of nerve roots in the spinal cord to alleviate symptoms of neuromuscular conditions. This procedure is typically performed through laminotomy or laminectomy and is done under general anesthesia.

2. Official Description

The official description of CPT code 63190 is: ‘Laminectomy with rhizotomy; more than 2 segments.’

3. Procedure

1. The patient is positioned face down, and the procedure is performed under general anesthesia.
2. An incision is made along the lower back to access the spinal cord.
3. The surgeon performs a laminectomy, exposing the sensory nerve roots at the center of the spinal cord.
4. Each individual nerve rootlet is electrically stimulated to identify the correct ones to be cut.
5. Any rootlets that cause spasticity when stimulated are cut.

4. Qualifying circumstances

CPT 63190 is used for cases where the laminectomy with rhizotomy procedure involves cutting nerve roots in more than two segments of the spinal cord. This procedure is typically performed to relieve symptoms of neuromuscular conditions. It is important to note that this procedure should only be performed by a qualified healthcare professional.

5. When to use CPT code 63190

CPT code 63190 should be used when the laminectomy with rhizotomy procedure involves cutting nerve roots in more than two segments of the spinal cord. It is important to accurately document the number of segments involved in the procedure to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 63190, the following documentation is required:

• Clear indication of the neuromuscular condition and the need for the laminectomy with rhizotomy procedure
• Documentation of the specific segments of the spinal cord where the nerve roots were cut
• Date and duration of the procedure
• Details of the surgical technique used
• Any complications or additional procedures performed
• Signature of the performing healthcare professional

7. Billing guidelines

When billing for CPT 63190, it is important to ensure that the procedure involves cutting nerve roots in more than two segments of the spinal cord. It is also crucial to follow any specific billing guidelines provided by insurance companies or payers. Additionally, it is important to accurately document and code any additional procedures or complications that may have occurred during the surgery.

8. Historical information

CPT 63190 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2009, with the description being updated to ‘Laminectomy with rhizotomy; more than two segments.’ It is important to stay updated with any changes or revisions to the code.

9. Examples

1. A patient undergoes a laminectomy with rhizotomy procedure involving the cutting of nerve roots in four segments of the spinal cord to alleviate symptoms of a neuromuscular condition.
2. A surgeon performs a laminectomy with rhizotomy procedure, cutting nerve roots in three segments of the spinal cord to relieve symptoms of a neuromuscular condition.
3. A patient undergoes a laminectomy with rhizotomy procedure involving the cutting of nerve roots in six segments of the spinal cord to alleviate symptoms of a neuromuscular condition.
4. A surgeon performs a laminectomy with rhizotomy procedure, cutting nerve roots in five segments of the spinal cord to relieve symptoms of a neuromuscular condition.
5. A patient undergoes a laminectomy with rhizotomy procedure involving the cutting of nerve roots in three segments of the spinal cord to alleviate symptoms of a neuromuscular condition.
6. A surgeon performs a laminectomy with rhizotomy procedure, cutting nerve roots in four segments of the spinal cord to relieve symptoms of a neuromuscular condition.
7. A patient undergoes a laminectomy with rhizotomy procedure involving the cutting of nerve roots in seven segments of the spinal cord to alleviate symptoms of a neuromuscular condition.
8. A surgeon performs a laminectomy with rhizotomy procedure, cutting nerve roots in six segments of the spinal cord to relieve symptoms of a neuromuscular condition.
9. A patient undergoes a laminectomy with rhizotomy procedure involving the cutting of nerve roots in five segments of the spinal cord to alleviate symptoms of a neuromuscular condition.
10. A surgeon performs a laminectomy with rhizotomy procedure, cutting nerve roots in seven segments of the spinal cord to relieve symptoms of a neuromuscular condition.