How To Use CPT Code 63700

CPT 63700 describes the repair of a birth defect known as a meningocele, where the meninges protrude through a defect in the skull or spinal column, forming a sac filled with cerebrospinal fluid. 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 63700?

CPT 63700 is used to describe the repair of a meningocele, a birth defect where the meninges, the membranous coverings of the brain and spinal cord, protrude through a defect in the skull or spinal column, forming a sac filled with cerebrospinal fluid. This code is specifically used when the diameter of the meningocele is less than 5 cm.

2. Official Description

The official description of CPT code 63700 is: ‘Repair of meningocele; less than 5 cm diameter.’

3. Procedure

1. The provider makes an incision adjacent to the bulging meningeal sac.
2. The incision is carried down and into the sac, avoiding neural structures.
3. The provider retracts the skin edges and mobilizes the nerve roots that extend into the spinal canal.
4. The nerve roots terminating in the sac are sacrificed.
5. The protruding neural tissues are pushed back into the spinal canal to restore the normal structure of the spinal cord.
6. The filum terminale connective tissue is located and sharply cut to release the associated connection of the spinal cord.
7. The dura membrane is dissected from the connective tissue.
8. The dural defect is closed in a watertight manner.
9. The closure is reinforced by suturing the paravertebral muscles and fascia in the midline.
10. The skin is sutured in layers and a sterile dressing is applied.

4. Qualifying circumstances

CPT 63700 is performed on patients with a meningocele, a birth defect where the meninges protrude through a defect in the skull or spinal column. The diameter of the meningocele must be less than 5 cm for this code to be applicable.

5. When to use CPT code 63700

CPT code 63700 should be used when the provider is performing a repair of a meningocele with a diameter less than 5 cm. It is important to accurately document the size of the meningocele to support the use of this code.

6. Documentation requirements

To support a claim for CPT 63700, the provider must document the following information:

• Patient’s diagnosis of a meningocele
• Size of the meningocele, confirming it is less than 5 cm in diameter
• Description of the procedure performed
• Details of the closure technique used
• Any additional procedures or complications encountered
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 63700, ensure that the procedure performed meets the criteria of repairing a meningocele with a diameter less than 5 cm. It is important to accurately document the size of the meningocele and the details of the procedure to support the use of this code. Complex skin repair is not included in this code and should be reported separately if performed.

8. Historical information

CPT 63700 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 added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs a repair of a meningocele with a diameter of 3 cm in an infant.
2. A surgeon repairs a meningocele measuring 4 cm in diameter in an adult patient.
3. A neurosurgeon performs a meningocele repair on a 2-year-old child with a meningocele measuring 2.5 cm in diameter.
4. A pediatric neurologist repairs a meningocele measuring 1.5 cm in diameter in a newborn baby.
5. A neurosurgeon performs a meningocele repair on a 6-month-old infant with a meningocele measuring 4.5 cm in diameter.
6. A provider repairs a meningocele measuring 3.5 cm in diameter in a teenager.
7. A surgeon performs a meningocele repair on a 9-year-old child with a meningocele measuring 2 cm in diameter.
8. A neurosurgeon repairs a meningocele measuring 4.8 cm in diameter in an adult patient.
9. A provider performs a meningocele repair on a 3-month-old baby with a meningocele measuring 2.8 cm in diameter.
10. A pediatric neurologist repairs a meningocele measuring 1.2 cm in diameter in a newborn baby.