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2025 CPT code 63066

Costovertebral approach with decompression of spinal cord or nerve root(s), thoracic; each additional segment (List separately in addition to code for primary procedure).

Use 63066 in conjunction with 63064. Do not report spine osteotomy codes 22206-22208 with 63066 for same-session, same-level services. For the application of caliper or tongs, use 20660. For the treatment of fracture or dislocation of the spine, see 22310-22327.

Modifiers may be applicable in certain situations, such as reduced services (52), discontinued procedure (53), or distinct procedural service (59).

Medical necessity should be established through documentation of the patient's symptoms, neurological findings, and imaging results demonstrating spinal cord or nerve root compression requiring surgical decompression.

The surgeon performs the decompression of the additional thoracic spinal segment(s) using a costovertebral approach following the primary procedure at the same session.This includes removing the source of compression, possible drain placement, and wound closure.

IMPORTANT:(For excision of thoracic intraspinal lesions by laminectomy, see 63266, 63271, 63276, 63281, 63286)

In simple words: This code is used for each additional segment of the thoracic spine (upper back) that is treated during a surgery to relieve pressure on the spinal cord or nerves. The surgery uses an approach through the ribs. It is always reported in addition to the main procedure code.

This add-on code describes the decompression of each additional thoracic spinal segment using a costovertebral approach during the same session as the primary procedure (63064). This approach involves accessing the spine through an incision where the ribs and vertebrae meet. The procedure aims to alleviate symptoms caused by spinal cord or nerve root compression, often due to a herniated disc.The surgeon removes the source of the compression and may insert a drain before closing the wound.

Example 1: A patient presents with multi-level thoracic disc herniations causing spinal cord compression at T4-T6.During the same surgical session, the surgeon performs a costovertebral approach decompression at T4 (63064), T5 (+63066), and T6 (+63066)., A patient undergoes a costovertebral approach for thoracic spinal stenosis at T9 and T10. Code 63064 is reported for the decompression at T9, and 63066 is reported for the decompression at T10., A patient has a thoracic disc herniation at T5 with nerve root compression.The surgeon performs a costovertebral approach decompression at T5.Since this is a single-level decompression, only 63064 would be reported.

Documentation should include the operative report detailing the costovertebral approach, the specific thoracic levels decompressed, the source of compression, any additional procedures performed (e.g., drain placement), and the patient's diagnosis. Imaging studies supporting the diagnosis should also be included.

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