How To Use CPT Code 63251

CPT 63251 describes the excision or occlusion of an arteriovenous malformation (AVM) of the spinal cord in the thoracic region. 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 63251?

CPT 63251 is used to describe a surgical procedure that involves the removal or closure of an abnormal tangle of arteries and veins in the spinal cord known as an arteriovenous malformation (AVM). This procedure specifically targets AVMs located within, on, or near the thoracic region of the spinal cord.

2. Official Description

The official description of CPT code 63251 is: ‘Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic.’

3. Procedure

1. During the procedure, the healthcare provider makes an incision over the thoracic vertebra where the AVM is located.
2. The provider then dissects through the tissue to reach the fascia, which is the firm membrane covering the spinous processes of the spine.
3. Next, the provider gains access to the spinal cord by carefully dissecting and retracting the soft tissues and muscles surrounding the spine.
4. A portion of the thoracic vertebra, called the lamina, is removed in a procedure known as a laminectomy.
5. Using an operating microscope for visualization, the provider opens the dural tube, which is the fibrous sheath covering the spinal cord.
6. The AVM is identified and either excised or surgically ligated using microsurgical techniques.
7. Once the procedure is complete, the provider sutures the dural tube, muscle and tissue layers, and closes the incision with sutures or staples.

4. Qualifying circumstances

CPT 63251 is performed on patients with neurological arteriovenous malformations (AVMs) of the spinal cord in the thoracic region. These AVMs cause abnormal communications between arteries and veins, leading to functional abnormalities such as lower extremity weakness. The procedure aims to isolate and eradicate the AVM, preventing further progression of the condition.

5. When to use CPT code 63251

CPT code 63251 should be used when a healthcare provider performs a laminectomy to excise or occlude an arteriovenous malformation (AVM) of the spinal cord in the thoracic region. This code is specific to AVMs located in the thoracic spine and should not be used for AVMs in other regions of the spine.

6. Documentation requirements

To support a claim for CPT 63251, the healthcare provider must document the following information:

• Patient’s diagnosis of a neurological arteriovenous malformation (AVM) of the spinal cord
• Details of the surgical procedure performed, including the specific vertebra involved and the approach used
• Description of the excision or occlusion of the AVM
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 63251, ensure that the procedure involves the excision or occlusion of an arteriovenous malformation (AVM) of the spinal cord in the thoracic region. It is important to use the appropriate CPT code based on the location of the AVM (63250 for cervical vertebra, 63251 for thoracic vertebra, and 63252 for thoracolumbar vertebra). Additionally, follow any specific guidelines provided by insurance carriers or payers regarding documentation and coding for this procedure.

8. Historical information

CPT 63251 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone no updates or changes since its addition. However, it is important to stay updated with any changes or revisions to coding guidelines and documentation requirements.

9. Examples

1. A healthcare provider performs a laminectomy to excise an arteriovenous malformation (AVM) of the thoracic spinal cord in a patient experiencing lower extremity weakness.
2. During a surgical procedure, a provider occludes an arteriovenous malformation (AVM) of the thoracic spinal cord to prevent further progression of the condition in a patient.
3. A patient with a neurological arteriovenous malformation (AVM) in the thoracic spinal cord undergoes a laminectomy for excision by a healthcare provider.
4. A healthcare provider performs a laminectomy to surgically ligate an arteriovenous malformation (AVM) of the thoracic spinal cord in a patient with functional abnormalities.
5. During a surgical procedure, a provider excises an arteriovenous malformation (AVM) of the thoracic spinal cord to resolve lower extremity weakness in a patient.
6. A patient with a neurological arteriovenous malformation (AVM) in the thoracic spinal cord undergoes a laminectomy for occlusion by a healthcare provider.
7. A healthcare provider performs a laminectomy to excise an arteriovenous malformation (AVM) of the thoracic spinal cord in a patient with functional abnormalities.