American Medical Association adds new, amended, and removed codes to the CTP code set, along with logic and rationale for the changes every year. The CPT code set for 2022 includes adjustments to guidelines, parenthetical remarks, definitions, and coding instructions for spinal fusions. Following are the significant changes in spinal fusions.
New CPT codes for Spinal Fusions
Two new codes have been established to report neural element decompression with laminectomy performed in conjunction with lumbar interbody fusion. The two new add-on codes are as follows.
- CPT Code 63052
- CPT Code 63053
CPT Code 63052: The American Medical Association maintains the Current Procedural Terminology (CPT®) code 63052, a medical procedural code in the range – of Posterior Extradural Laminectomy for exploration of neural elements or excision of herniated intervertebral disks procedures. This code describes first-level decompressions.
CPT Code 63053: CPT Code 63053 deals with each additional vertebral segment. This code describes another level of decompression.
CPT Code 63053 must be used in conjunction with CPT Code 63052.
Along with the new add-on codes, many revisions were made to the guidelines and instructions for laminectomy-based interbody fusion surgeries to clarify the following:
- New codes 63052 and 63053 may be reported as add-on services only when a decompressive laminectomy (together with any other decompressive treatment, such as foraminotomy or Facetectomy) is performed in addition to interbody fusion procedures (i.e., the fusion procedures identified by codes 22630-22634). As a result, codes 63052 and 63053 should not be used in conjunction with other fusion operations.
- If only decompressive laminectomy is performed, the existing laminectomy codes may be recorded.
- If the laminectomy is performed to prepare the interspace for fusion, codes 63052 and 63053 should not be recorded.
CPT Codes 63052 and 63053 should be reported with the below-mentioned codes.
CPT Code 22630: Arthrodesis, posterior interbody method, incorporating laminectomy and discectomy to prepare interspace (except for decompression), single interspace
CPT Code 22632: Arthrodesis, posterior interbody method, incorporating laminectomy and/or discectomy to create interspace (other than for decompression), single interspace
CPT Code 22633: Arthrodesis, coupled posterior or posterolateral technique with posterior interbody method incorporating laminectomy and discectomy adequate to create interspace (other than for decompression), single interspace and level; lumbar.
CPT Code 22634: Arthrodesis, coupled posterior or posterolateral technique with posterior interbody technique, comprising laminectomy and discectomy enough to create interspace (other than for decompression), single interspace, and segment.
Terminologies Associated With Spinal Fusion
Corpectomy: Identifies the surgical removal of a vertebral body.
Facetectomy: Facet joint excision between two vertebral bodies. There are two facet joints in each spinal segment.
Foraminotomy: The removal of bone to enlarge the intervertebral foramen. The primary notch of the neighboring vertebra, the inferior crack of the vertebra, the facet joint, and the intervertebral disc surround the intervertebral foramen.
Hemilaminectomy: The removal of a section of the vertebral lamina, usually to explore, access, or decompress the extraspinal contents.
Lamina: The flattened posterior section of the vertebral arch stretching between the pedicles and the midline, forming the dorsal wall of the vertebral foramen, and from which the spinous process extends, is referred to as the lamina.
Laminectomy: This is a surgery that removes the lamina to make room.
Laminotomy: Laminotomy and laminectomy are procedures that remove part or all of a spinal bone known as the lamina.
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