How To Use CPT Code 63741

CPT 63741 describes the percutaneous creation of a shunt in the lumbar region, subarachnoid-peritoneal, -pleural, or other areas, without the need for a laminectomy. 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 63741?

CPT 63741 can be used to describe the percutaneous creation of a shunt in various areas, such as the lumbar region, subarachnoid-peritoneal, -pleural, or other areas. This procedure involves the insertion of a small tube, known as a shunt, to drain cerebrospinal fluid (CSF) from the subarachnoid space surrounding the spinal cord. The purpose of this procedure is to reduce pressure and divert excess CSF to the abdominal or thoracic cavity, or another designated area. Unlike other shunt procedures, CPT 63741 does not require a laminectomy.

2. Official Description

The official description of CPT code 63741 is: ‘Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy.’

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. An incision is made over the selected lumbar vertebrae to access the spinal cord.
3. The provider inserts a shunt, which is a small catheter, between two lumbar vertebrae and into the cavity surrounding the spinal cord.
4. A spinal needle is then inserted into the subarachnoid space, and a lumbar shunt system is passed through the needle and into the space.
5. The provider confirms the flow of CSF and tunnels the catheter under the skin, around the patient’s side, over the hip bone or rib cage, to the designated cavity.
6. To reduce the risk of catheter movement, the provider may use a purse string suture, which is a continuous, circular, inverting suture around the catheter.
7. Once the procedure is complete, the provider closes the incision in layers and applies sterile dressings.

4. Qualifying circumstances

CPT 63741 is performed on patients who require the placement of a shunt to drain excess cerebrospinal fluid. The procedure is indicated for conditions that cause an overabundance of CSF, such as hydrocephalus. It is important to note that CPT 63741 does not involve the excision of the lamina, unlike other shunt procedures.

5. When to use CPT code 63741

CPT code 63741 should be used when a percutaneous shunt creation procedure is performed without the need for a laminectomy. It is important to accurately document the specific areas where the shunt is placed, such as the lumbar region, subarachnoid-peritoneal, -pleural, or other areas.

6. Documentation requirements

To support a claim for CPT 63741, the provider must document the following information:

• Patient’s diagnosis necessitating the shunt placement
• Specific areas where the shunt is placed (e.g., lumbar, subarachnoid-peritoneal, -pleural, or other)
• Date of the procedure
• Details of the procedure, including the steps performed
• Confirmation of CSF flow
• Use of a purse string suture, if applicable
• Closure of the incision and application of sterile dressings

7. Billing guidelines

When billing for CPT 63741, ensure that the procedure does not involve a laminectomy. It is important to accurately report the specific areas where the shunt is placed. Additionally, follow any specific guidelines provided by payers regarding the documentation and reporting of this procedure.

8. Historical information

CPT 63741 was added to the Current Procedural Terminology system on January 1, 1991. There have been no updates or changes to the code since its addition.

9. Examples

1. A neurosurgeon performs a percutaneous shunt creation procedure in the lumbar region to drain excess cerebrospinal fluid in a patient with hydrocephalus.
2. An interventional radiologist inserts a shunt in the subarachnoid-pleural space to divert cerebrospinal fluid in a patient with a CSF leak.
3. A neurologist performs a percutaneous shunt creation procedure in an alternative area to drain excess cerebrospinal fluid in a patient with pseudotumor cerebri.
4. A neurosurgeon places a shunt in the lumbar region to divert cerebrospinal fluid in a patient with normal pressure hydrocephalus.
5. An interventional radiologist performs a percutaneous shunt creation procedure in the subarachnoid-peritoneal space to drain excess cerebrospinal fluid in a patient with arachnoiditis.
6. A neurologist inserts a shunt in an alternative area to divert cerebrospinal fluid in a patient with a spinal cord injury.
7. A neurosurgeon performs a percutaneous shunt creation procedure in the lumbar region to drain excess cerebrospinal fluid in a patient with a brain tumor.