How To Use CPT Code 63655

CPT 63655 describes the procedure of laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 63655?

CPT 63655 can be used to describe the surgical procedure in which a portion of the vertebra called the lamina is removed, and permanent plate/paddle electrodes are placed in the epidural space for spinal cord stimulation. This procedure is performed to control pain and spasms in patients who require a larger area of coverage or to reduce the risk of movement of the electrode array.

2. Official Description

The official description of CPT code 63655 is: ‘Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural.’

3. Procedure

1. The provider begins by carefully placing permanent plate/paddle electrodes in the epidural space for spinal cord stimulation.
2. He anchors the electrodes to the interspinal ligaments and positions and implants a pulse generator.
3. Using fluoroscopy, the provider verifies the location of the percutaneous leads and makes an incision over the site on the spine.
4. He dissects through the tissue, fascia, and muscles to expose the spinous processes and lamina.
5. The provider removes the portion of the vertebra over the location of the percutaneous leads and removes the leads.
6. He places the plate/paddle lead into the epidural space closest to the point to be treated and verifies the exact placement using fluoroscopy.
7. The provider tests the leads, anchors the plate or paddle to prevent movement, and passes the extension lead subcutaneously using a tunneling device.
8. He makes an incision in the lower abdomen to implant the neurostimulator or electronic pulse generator and connects the lead or leads to the generator.
9. The provider tests the leads again to ensure proper functioning, secures the generator under the skin, and closes the incision.
10. Finally, he closes the spinal incision in layers and applies stimulation within days after the procedure.

4. Qualifying circumstances

CPT 63655 is performed on patients who require spinal cord stimulation for pain and spasms control. The procedure involves the careful placement of permanent plate/paddle electrodes in the epidural space. It is important to note that this procedure is performed by a provider who is experienced in spinal cord stimulation techniques.

5. When to use CPT code 63655

CPT code 63655 should be used when a laminectomy is performed for the implantation of neurostimulator electrodes, plate/paddle, epidural. It is appropriate to use this code when the provider is placing permanent electrodes in the epidural space for spinal cord stimulation.

6. Documentation requirements

To support a claim for CPT 63655, the provider must document the following information:

• Patient’s diagnosis and the need for spinal cord stimulation
• Specific details of the procedure, including the placement of plate/paddle electrodes and the implantation of the pulse generator
• Date of the procedure
• Verification of the location of the percutaneous leads using fluoroscopy
• Testing of the leads to ensure proper functioning
• Details of any additional procedures performed, such as the implantation of the neurostimulator or electronic pulse generator
• Postoperative care provided to the patient

7. Billing guidelines

When billing for CPT 63655, ensure that the procedure involves the laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural. It is important to note that the implantation of the spinal neurostimulator pulse generator or receiver is a separately reportable procedure under CPT code 63685. Modifier 58 may need to be appended to CPT 63655 and CPT 63685 if the provider performs these services during the postoperative period of the initial trial insertion. Modifier 59 should be appended to CPT 63655 if the surgeon places a paddle or plate type array at a different anatomical site from the previously placed trial leads.

8. Historical information

CPT 63655 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with chronic back pain undergoes a laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural to control their pain and improve their quality of life.
2. A provider performs a laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural on a patient with severe spasms to help manage their symptoms and improve their mobility.
3. A patient with neuropathic pain undergoes a laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural to provide targeted pain relief and reduce their reliance on medication.
4. A provider performs a laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural on a patient with failed back surgery syndrome to help alleviate their persistent pain and improve their overall function.
5. A patient with complex regional pain syndrome undergoes a laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural to help manage their symptoms and improve their quality of life.
6. A provider performs a laminectomy for the implantation of neurostimulator electrodes, plate/paddle, epidural on a patient with cancer-related pain to provide targeted pain relief and improve their comfort.