CPT® Code 0172T

Deleted

Insertion of posterior spinous process distraction device (including necessary removal of bone or ligament for insertion and imaging guidance), lumbar; each additional level (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 0172T involves the insertion of a posterior spinous process distraction device specifically in the lumbar region of the spine. This procedure is performed at each additional level beyond the primary procedure and includes the necessary removal of bone or ligament to facilitate the insertion of the device, as well as imaging guidance to ensure proper placement. The posterior spinous process distraction device is utilized in the treatment of lumbar stenosis, a condition characterized by the narrowing of the spinal canal, which can lead to pressure on the spinal cord and nerves. This condition is often associated with degeneration of the intervertebral discs and a reduction in disc height, which may result in symptoms such as neurogenic claudication, where patients experience pain or discomfort in the legs during physical activity. During the procedure, a surgical incision is made over the affected intervertebral disc space, allowing access through the subcutaneous tissue and lumbosacral fascia to expose the inferior and superior spinous processes, as well as the interspinous ligament. The surgical team may remove bone from the exposed spinous processes to create sufficient space for the device. Lamina spreaders are then inserted between the lamina of adjacent vertebral segments to apply distraction, thereby enlarging the intervertebral opening. The interspinous ligament may also be excised if necessary. Following the creation of this space, the interspinous distraction device is carefully inserted between the spinous processes into the defect created during the procedure. Once the device is in place, distraction is discontinued, and the lamina spreaders are removed. Throughout the procedure, intraoperative imaging and/or fluoroscopy may be employed to verify the alignment and positioning of the IPD device, ensuring optimal outcomes for the patient. The use of code 0172T is mandated for each additional lumbar level treated with the insertion of the IPD device.