Thoracic Calcified Disc

Question:

The documentation indicates a costovertebral approach and rib removal to access and dissect a calcified thoracic disc at T9-T10. How is this coded? And can the rib removal be reported separately?

Answer:

This is most likely coded as 63064, Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment. The rib removal is included. A costotranversectomy for the rib removal, is included and not separately reported.

*This response is based on the best information available as of 5/22/25.

Costotransversectomy Included in Transthoracic Corpectomy

Question:

Is a costotransversectomy included with transthoracic corpectomies?

Answer:

Yes.  A costotransversectomy involves removing a rib or ribs for a thoracic approach to the spine and is always included as part of the approach in a transthoracic corpectomy. 

*This response is based on the best information available as of 5/8/25.

Documentation to Support Modifier 22

Question:

When performing spinal procedures, does documentation of obesity support the use of modifier 22?

Answer:

Documentation of obesity alone does not support the use of modifier 22, however, additional information indicating the patient’s obesity resulted in a procedure that was technically more difficult, or required more time than normal (i.e., suggesting that the neck was thick, positioning was difficult, more time was spent), could support the use of modifier 22.

*This response is based on the best information available as of 4/24/25.

Synthetic Graft to Close Dura

Question:

After performing a craniotomy for tumor removal, the dura was repaired with a synthetic graft. What code is used for the synthetic graft?

Answer:

Repairing the dura after a craniotomy with a synthetic graft is included in the craniotomy code. No additional code is reported.

*This response is based on the best information available as of 4/10/25.

Primary Difference in Lumbar Laminectomy Codes

Question:

What is the primary difference between lumbar laminectomy CPT codes 63030 and 63047?

Answer:

The primary difference in use of these CPT codes is the diagnosis; CPT code 63030 is for removal of a disc due to herniation or degenerative disc disease and CPT code 63047 is for decompression of the nerve due to stenosis or spondylosis.

*This response is based on the best information available as of 3/27/25.

Vertebral Segment vs Motion Segment

Question:

What is the difference between a vertebral segment and a “motion segment”?

Answer:

A vertebral segment represents a single vertebral bone with its associated articular processes and lamina.  A “motion segment” refers to 2 vertebral segments and the vertebral interspace (non-bony compartment between two adjacent vertebral bodies) between.

*This response is based on the best information available as of 3/13/25.