How To Use CPT Code 63744

CPT 63744 describes the replacement, irrigation, or revision of a shunt previously placed in the lumbosubarachnoid region. 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 63744?

CPT 63744 can be used to describe the replacement, irrigation, or revision of a shunt that was previously placed in the lumbosubarachnoid region. This code is used when the healthcare provider performs a procedure to either replace a malfunctioning shunt with a new one or irrigate the existing shunt to ensure proper functioning.

2. Official Description

The official description of CPT code 63744 is: ‘Replacement, irrigation or revision of lumbosubarachnoid shunt.’

3. Procedure

1. The healthcare provider begins by identifying the site of the original incision from the shunt creation.
2. A new incision is made in the same area to gain access to the shunt.
3. Any adhesions are incised, and the paravertebral muscles, fascia, and ligaments are retracted to reach the shunt.
4. If the shunt is not working properly, the provider may irrigate it with saline to clear any blockages or obstructions.
5. If the shunt cannot be salvaged, the provider replaces it with a new shunt.
6. The wound is then closed by suturing the layers of tissue together.

4. Qualifying circumstances

CPT 63744 is performed when there is a need to replace or irrigate a shunt that has been previously placed in the lumbosubarachnoid region. This procedure is typically indicated when the shunt is malfunctioning or not draining excess cerebrospinal fluid properly. It is important to note that this procedure should only be performed by a qualified healthcare provider with the necessary expertise in shunt replacement or irrigation.

5. When to use CPT code 63744

CPT code 63744 should be used when a healthcare provider performs the replacement, irrigation, or revision of a shunt in the lumbosubarachnoid region. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure does not involve the lumbosubarachnoid region or does not involve the replacement, irrigation, or revision of a shunt, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 63744, the healthcare provider must document the following information:

• Reason for the procedure and the need for shunt replacement, irrigation, or revision
• Details of the procedure, including the specific steps taken and any complications encountered
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 63744, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the procedure and any additional procedures performed during the same session. CPT code 63744 should not be reported if the shunt is removed without replacement. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 63744 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 neurosurgeon performs a procedure to replace a malfunctioning lumbosubarachnoid shunt in a patient with hydrocephalus.
2. A neurologist irrigates a lumbosubarachnoid shunt in a patient with normal pressure hydrocephalus to ensure proper functioning.
3. A pediatric surgeon performs a revision of a lumbosubarachnoid shunt in a child with spina bifida to address complications.
4. An interventional radiologist replaces a blocked lumbosubarachnoid shunt in a patient with pseudotumor cerebri.
5. A neurosurgeon performs a revision of a lumbosubarachnoid shunt in a patient with arachnoiditis to improve cerebrospinal fluid drainage.
6. A neurologist irrigates a lumbosubarachnoid shunt in a patient with normal pressure hydrocephalus to clear any obstructions.
7. A pediatric surgeon replaces a malfunctioning lumbosubarachnoid shunt in an infant with congenital hydrocephalus.
8. An interventional radiologist performs a revision of a lumbosubarachnoid shunt in a patient with a shunt infection.
9. A neurosurgeon replaces a blocked lumbosubarachnoid shunt in a patient with idiopathic intracranial hypertension.
10. A neurologist irrigates a lumbosubarachnoid shunt in a patient with normal pressure hydrocephalus to improve cerebrospinal fluid flow.