2025 CPT code 63173
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spinal Procedures Surgery Feed
Laminectomy with drainage of intramedullary cyst/syrinx to peritoneal or pleural space.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 59 for distinct procedural service, 22 for increased procedural service, 51 for multiple procedures).
Medical necessity is established by documentation of a symptomatic intramedullary cyst or syrinx causing neurological deficits or significant pain refractory to conservative management. Imaging studies should confirm the presence and location of the cyst and its relationship to the spinal cord.The procedure should be deemed medically necessary by the attending physician and should meet the payer's specific criteria for coverage.
The surgeon is responsible for pre-operative preparation, anesthesia administration, incision and wound closure, muscle retraction, performing the laminectomy to access the cyst, placement of the spinal needle for drainage, and post-operative care.
In simple words: The surgeon removes a portion of the vertebra's bone to drain a fluid-filled cyst in the spinal cord. The fluid is drained into either the abdomen or chest cavity.
This procedure involves a laminectomy, the surgical removal of the lamina (posterior arch of a vertebra), to access and drain an intramedullary cyst or syrinx (fluid-filled cyst within the spinal cord). The drainage is directed either into the peritoneal space (abdominal cavity) or the pleural space (chest cavity).The procedure includes incision, muscle retraction, laminectomy, cyst drainage via spinal needle placement, and layered wound closure.
Example 1: A patient presents with a syrinx in the thoracic spinal cord causing progressive weakness and pain.A laminectomy with drainage into the pleural space is performed to alleviate pressure and improve neurological function., A patient has a large intramedullary cyst in the lumbar region causing significant pain and compression of the nerve roots.A laminectomy with peritoneal drainage is undertaken to relieve the pressure and reduce symptoms., A patient with a known spinal cord cyst experiences a sudden increase in pain and neurological deficit. Emergency laminectomy with drainage into the peritoneal cavity is performed to immediately relieve the pressure and potentially prevent further neurological damage.
Detailed medical history including symptoms, neurological examination findings, imaging studies (MRI, CT), operative report detailing the approach, location and size of the cyst, method of drainage, and amount of fluid drained, pathology report if applicable, and post-operative neurological assessment.
** This code is used for cases where drainage of the cyst is directed into either the peritoneal or pleural space, not the subarachnoid space (which is coded as 63172).The choice of drainage site is determined by the surgeon based on the location of the cyst and the patient's overall condition.
- Revenue Code: P1F (Major Procedure - Explor/Decompr/Excis Disc)
- Payment Status: Active
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center