How To Use CPT Code 63273

CPT 63273 describes the excision of an intraspinal lesion other than a neoplasm through a laminectomy procedure on the sacral vertebra. 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 63273?

CPT 63273 can be used to describe the excision of an intraspinal lesion, excluding neoplasms, through a laminectomy procedure specifically on the sacral vertebra. This code is used when a provider removes a portion of the sacral vertebra called the lamina and excises an intradural lesion of the spinal cord, which is located inside the dura, the tough outer membrane surrounding the central nervous system.

2. Official Description

The official description of CPT code 63273 is the excision of an intraspinal lesion other than a neoplasm through a laminectomy procedure on the sacral vertebra. It is important to note that this code is added under the Inpatient Only (IPO) list for Medicare billing purposes.

3. Procedure

1. During the laminectomy procedure, the provider makes an incision on the sacral vertebra and removes a portion of the lamina, which is the posterior arch of the vertebra.
2. The provider then gains access to the spinal cord by retracting the soft tissues and paravertebral muscles.
3. Next, the provider incises the dura, the outer covering of the spinal cord, to locate the intradural lesion.
4. The provider carefully excises the intradural lesion, ensuring to remove any excess fluid or blood using a drain if necessary.
5. Finally, the provider closes the wound in layers and applies a sterile dressing.

4. Qualifying circumstances

CPT 63273 is used for patients who require the excision of an intraspinal lesion other than a neoplasm through a laminectomy procedure specifically on the sacral vertebra. The procedure is performed by a qualified provider and is typically reserved for cases where the lesion is located inside the dura, the outermost layer surrounding the spinal cord.

5. When to use CPT code 63273

CPT code 63273 should be used when a provider performs a laminectomy procedure to excise an intraspinal lesion other than a neoplasm specifically on the sacral vertebra. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 63273, the provider must document the following information:

• Patient’s diagnosis necessitating the excision of the intraspinal lesion
• Details of the laminectomy procedure performed, including the specific vertebra and the portion of the lamina removed
• Description of the intradural lesion and its location
• Any additional procedures performed, such as fluid or blood drainage
• Wound closure details and application of a sterile dressing

7. Billing guidelines

When billing for CPT 63273, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that this code is added under the Inpatient Only (IPO) list for Medicare billing purposes. Additionally, consider using code 63268 if the provider performs a similar procedure for an extradural intraspinal sacral lesion.

8. Historical information

CPT 63273 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 provider performs a laminectomy procedure on the sacral vertebra to excise an intradural lesion in a patient with spinal cord compression.
2. A patient presents with an intraspinal lesion other than a neoplasm located inside the dura on the sacral vertebra. The provider performs a laminectomy procedure to remove the lesion and relieve symptoms.
3. A provider performs a laminectomy procedure on the sacral vertebra to excise an intradural lesion causing neurological deficits in a patient.
4. A patient undergoes a laminectomy procedure on the sacral vertebra to remove an intraspinal lesion other than a neoplasm that is causing severe pain and dysfunction.
5. A provider performs a laminectomy procedure on the sacral vertebra to excise an intradural lesion that is compromising the patient’s spinal cord function.
6. A patient with an intraspinal lesion other than a neoplasm located inside the dura on the sacral vertebra undergoes a laminectomy procedure to remove the lesion and prevent further complications.
7. A provider performs a laminectomy procedure on the sacral vertebra to excise an intradural lesion causing sensory disturbances in a patient.
8. A patient presents with an intraspinal lesion other than a neoplasm located inside the dura on the sacral vertebra. The provider performs a laminectomy procedure to remove the lesion and restore neurological function.
9. A provider performs a laminectomy procedure on the sacral vertebra to excise an intradural lesion that is causing motor deficits in a patient.