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2025 CPT code 63064

Costovertebral approach with decompression of spinal cord or nerve root(s) (e.g., herniated intervertebral disc), thoracic; single segment.

Refer to the most recent CPT® manual for detailed coding guidelines and updates.

Modifiers 51 (multiple procedures), 52 (reduced services), 59 (distinct procedural service), and others as clinically indicated.

Medical necessity for 63064 is established by documentation of significant clinical symptoms attributable to spinal cord or nerve root compression in the thoracic spine, such as radiculopathy, myelopathy, or significant pain refractory to conservative management.Pre-operative imaging findings must correlate with the clinical presentation.

The clinical responsibility lies with the surgeon performing the procedure. This includes pre-operative assessment, surgical planning, executing the costovertebral approach,decompression of the spinal cord or nerve root(s), wound closure, and post-operative care.

IMPORTANT:For multiple segments at the same session, report 63066 for each additional segment.Do not report spine osteotomy codes (22206-22208) with 63064 for same-session, same-level services. Instrumentation, device, and fixation codes (22840-22848 and 22853-22870) may be reported at the same session.

In simple words: This code represents surgery to relieve pressure on the spinal cord or nerves in the upper back.The surgeon operates through an incision near the ribs and spine to remove the source of the pressure, such as a slipped disc.

This CPT code 63064 describes a surgical procedure involving a costovertebral approach to decompress the spinal cord or nerve roots in a single thoracic segment.The approach accesses the spine through an incision near the ribs and vertebrae. The procedure aims to relieve pressure caused by conditions such as a herniated intervertebral disc. The surgeon may utilize instruments like drills or rongeurs to access the affected area, remove the compression source, and potentially insert a drain before closing the incision in layers.

Example 1: A patient presents with severe thoracic radiculopathy secondary to a herniated T6-T7 disc. The surgeon performs a costovertebral approach to remove the herniated disc material, decompressing the nerve root., A patient experiences persistent pain and weakness in the upper back due to spinal stenosis at the T4 level.A costovertebral decompression is performed to alleviate compression on the spinal cord., A patient undergoes a laminectomy for thoracic spinal stenosis, and during the procedure, the surgeon encounters significant nerve root compression at T8, necessitating a costovertebral decompression at that level.

* Pre-operative imaging (e.g., MRI, CT scan) demonstrating the need for decompression.* Operative report detailing the approach, procedure performed, and findings.* Anesthesia record.* Pathology report (if applicable).* Post-operative imaging (if applicable).

** This code is specific to a single thoracic segment.Additional codes (e.g., 63066) are necessary for multiple segments.Always ensure proper documentation supports medical necessity and accurate coding.

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