How To Use CPT Code 63307

CPT code 63307 describes the excision of an intraspinal lesion within the lumbar or sacral spine using a transperitoneal or retroperitoneal approach. 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 63307?

CPT 63307 is used to describe the excision of an intraspinal lesion within the lumbar or sacral spine. This procedure involves the removal of a partial or complete segment of the vertebral body using either a transperitoneal or retroperitoneal approach. The purpose of this excision is to relieve pressure on the spinal cord caused by the intradural lesion.

2. Official Description

The official description of CPT code 63307 is: ‘Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach.’

3. Procedure

1. The provider makes an incision either through the abdomen (transperitoneal approach) or through the back (retroperitoneal approach) to access the lumbar or sacral spine.
2. Using surgical instruments, the provider removes the diseased or damaged portion of the vertebral body, which includes the intradural lesion.
3. If necessary, the provider may also remove the intervertebral discs above and below the excised segment.
4. To stabilize the spine, the provider inserts bolts or screws above and below the excised segment.
5. A bone graft is then inserted into the vertebral gap to promote fusion and stability.
6. To further enhance stability, a metal plate may be inserted and secured to the vertebrae.
7. The incision is closed, and the patient is monitored for any post-operative complications.

4. Qualifying circumstances

CPT 63307 is performed on patients with intradural lesions within the lumbar or sacral spine. The procedure is typically reserved for cases where the lesion is causing significant pressure on the spinal cord and other conservative treatment options have been exhausted. The provider must use either a transperitoneal or retroperitoneal approach to access the affected area.

5. When to use CPT code 63307

CPT code 63307 should be used when a provider performs a vertebral corpectomy to excise an intraspinal lesion within the lumbar or sacral spine. This code is specific to cases where the lesion is intradural and requires a transperitoneal or retroperitoneal approach. It is important to note that CPT code 63307 should not be used for lesions in other regions of the spine or for lesions that are extradural.

6. Documentation requirements

To support a claim for CPT code 63307, the provider must document the following information:

• Patient’s diagnosis and the presence of an intradural lesion within the lumbar or sacral spine
• Approach used (transperitoneal or retroperitoneal)
• Date of the procedure
• Details of the excision, including the extent of the vertebral body resection
• Any additional procedures performed, such as removal of intervertebral discs or insertion of bolts, screws, bone grafts, or metal plates
• Any post-operative complications or follow-up care provided
• Provider’s signature

7. Billing guidelines

When billing for CPT code 63307, ensure that the procedure meets the specific criteria outlined in the code description. The provider must perform a vertebral corpectomy for the excision of an intradural lesion within the lumbar or sacral spine using a transperitoneal or retroperitoneal approach. It is important to note that CPT code 63307 should not be reported with other codes for excision of vertebral bodies in different regions of the spine or for extradural lesions.

8. Historical information

CPT code 63307 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. In 2017, it was also added to the Inpatient Only (IPO) list for Medicare reimbursement purposes.

9. Examples

1. A patient undergoes a vertebral corpectomy using a transperitoneal approach to remove an intradural lesion within the lumbar spine.
2. A provider performs a retroperitoneal vertebral corpectomy to excise an intradural lesion within the sacral spine.
3. Using a transperitoneal approach, a surgeon performs a vertebral corpectomy to remove an intradural lesion within the lumbar spine and inserts bolts for stabilization.
4. A patient undergoes a retroperitoneal vertebral corpectomy to excise an intradural lesion within the sacral spine and receives a bone graft for fusion.
5. A provider performs a transperitoneal vertebral corpectomy to remove an intradural lesion within the lumbar spine and inserts a metal plate for additional stability.
6. Using a retroperitoneal approach, a surgeon performs a vertebral corpectomy to excise an intradural lesion within the sacral spine and removes intervertebral discs above and below the excised segment.
7. A patient undergoes a transperitoneal vertebral corpectomy to remove an intradural lesion within the lumbar spine and receives post-operative monitoring for any complications.