2025 CPT code 63090
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina, or nerve root(s), lower thoracic, lumbar, or sacral; single segment.
Modifiers 59 (distinct procedural service) and 62 (two surgeons) may be applicable depending on the specific circumstances.
Medical necessity for a vertebral corpectomy is established when conservative management (e.g., medications, physical therapy) has failed to alleviate symptoms and the patient demonstrates significant neurological deficits or spinal instability due to vertebral compression.
The surgical resection of the vertebral body, decompression of the neural structures, and any necessary spinal reconstruction or stabilization are the clinical responsibilities of the surgeon.
In simple words: The doctor removes part or all of a vertebra (bone in the lower back) through an incision in the abdomen or side. This is done to relieve pressure on the spinal cord or nerves causing pain or weakness.The procedure focuses on a single bone segment in the lower back.
This CPT code 63090 represents a vertebral corpectomy, which involves the partial or complete surgical excision of a lower thoracic, lumbar, or sacral vertebra.The procedure is performed via a transperitoneal (abdominal) or retroperitoneal (anterolateral) approach, encompassing decompression of the spinal cord, cauda equina, and/or nerve roots at a single vertebral segment.The approach chosen depends on the surgeon's preference and the specific anatomical location.Decompression involves relieving pressure on the neural structures to alleviate symptoms caused by compression.
Example 1: A patient presents with severe lower back pain and neurological deficits due to a large herniated disc compressing the cauda equina.A posterior lumbar vertebral corpectomy (63090) is performed to remove the compromised vertebral body and decompress the cauda equina., A patient with a pathologic fracture of a lumbar vertebra resulting from metastatic cancer requires a corpectomy to remove the unstable vertebral body.The corpectomy is performed, followed by stabilization with instrumentation (separate code)., A patient with spinal stenosis experiences significant lower extremity weakness.A single-level anterior lumbar corpectomy (63090) is performed to remove a portion of the vertebral body, widening the spinal canal and relieving nerve root compression.Following the corpectomy, an interbody fusion is performed using an allograft.
* Preoperative diagnosis and imaging studies (X-rays, CT scan, MRI) demonstrating the need for corpectomy.* Operative report detailing the surgical approach (transperitoneal or retroperitoneal), extent of vertebral resection, decompression techniques employed, and any additional procedures performed.* Postoperative imaging studies to confirm the success of the procedure and assess for complications.* Progress notes documenting the patient's clinical course, response to treatment, and any complications encountered.
** Thorough documentation is crucial for accurate coding and reimbursement.Any discrepancies between the operative report and the billed codes should be addressed.
- Revenue Code: P1F (Major Procedure - Explor/Decompr/Excis Disc)
- RVU: The RVUs for this code vary depending on geographic location, facility type, and other factors.Consult the current Medicare Physician Fee Schedule or other relevant payer's fee schedule for the most accurate information.
- Global Days: The global surgical period for this procedure is not specified in the provided data. The duration of the global period might be 10 or 90 days depending on payer guidelines and the complexity of the procedure.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier depends on the payer and specific circumstances.There's no explicit information available about TC modifier usage for this code.
- Fee Schedule: Historical fee schedule information is not provided.Consult fee schedules from previous years or third-party billing databases for relevant historical data.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center