2025 CPT code 63290
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision by Laminectomy of Lesion Other Than Herniated Disk Procedures Surgical Procedures on the Spine and Spinal Cord Feed
Laminectomy for biopsy/excision of an intraspinal neoplasm involving both extradural and intradural areas at any spinal level.
Modifiers may be applied depending on the circumstances of the procedure.Consult the most current AMA CPT manual for applicable modifiers.
The medical necessity for this procedure is established by the presence of an extradural-intradural spinal tumor causing significant neurological compromise and/or pain that is not responsive to conservative management.The procedure is aimed at relieving neurological compression and improving the patient's quality of life.Documentation must clearly support the need for surgical intervention.
The clinical responsibility lies with a neurosurgeon or spine surgeon. This involves preoperative planning, surgical execution (including incision, laminectomy, dural incision, tumor excision, biopsy, and wound closure), and postoperative care.The surgeon's role also includes interpreting pathology results and managing any complications.
- Surgical Procedures on the Spine and Spinal Cord
- Surgical Procedures on the Spine and Spinal Cord; Excision by Laminectomy of Lesion Other Than Herniated Disk Procedures
In simple words: The doctor removes part of a vertebra (the bony part of the spine) to reach and remove a tumor on the spinal cord.The tumor may be both outside and inside a protective membrane surrounding the spinal cord. A small sample of the tumor is sent to a lab for testing. The wound is then closed.
This procedure involves a laminectomy to access and remove a spinal neoplasm that extends both outside (extradural) and inside (intradural) the dura mater.The lamina, a portion of the vertebra, is removed to expose the spinal cord.The dura is incised to access the intradural portion of the tumor. Using loupe magnification or an operating microscope, the surgeon completely excises the tumor, taking care to preserve the spinal cord's integrity. A portion of the lesion is sent for pathological examination.The wound is then closed in layers.
Example 1: A 55-year-old male presents with progressive weakness and sensory changes in his lower extremities. Imaging reveals an extradural-intradural spinal tumor at the T12-L1 level.Code 63290 is used to describe the laminectomy and excision of the tumor with a biopsy being sent to pathology., A 70-year-old female with a history of metastatic breast cancer experiences sudden onset of back pain and radiculopathy. Imaging shows an intradural-extradural metastasis at the L3-L4 level. Code 63290 is used for the surgical removal of the lesion., A 30-year-old presents with progressive neurological deficits and a suspected intradural extramedullary spinal tumor at the cervical spine (C5-C6). Code 63290 would be applied to the surgical procedure to remove the tumor and obtain a biopsy sample.
* Preoperative imaging (MRI, CT myelogram) demonstrating the location, size, and extent of the lesion.* Operative report detailing the surgical technique, amount of tissue resected, and assessment of margins.* Pathology report confirming the diagnosis and grading of the tumor.* Postoperative neurological examination documenting the patient's functional status.
** This code is used for lesions other than herniated disks.The location and size of the lesion will influence the surgical approach and the extent of the laminectomy.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided sources.To obtain RVU data, please consult the AMA CPT codebook or your payer's specific fee schedule.
- Global Days: The global period for this procedure is not specified in the provided data.The length of the global period will vary depending on payer and other factors.
- Payment Status: Active
- Modifier TC rule: The provided data does not specify whether or not a TC modifier is applicable.This should be determined based on the individual circumstances of the procedure, considering the extent of the surgical intervention.
- Fee Schedule: Historical fee schedule data is not available in the source. This information varies widely by payer and location.
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center