CPT® Code 63048

Add-On Code

Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)

Laminectomy, also known as lamina excision, is a surgical procedure aimed at alleviating back pain and relieving pressure on the spinal cord, spinal nerve roots, and/or cauda equina. The lamina refers to the bony structure that forms the posterior aspect of the vertebral arch, which is crucial for protecting the spinal cord. During the procedure, a posterior skin incision is made over the affected area of the spine, allowing access to the lamina. The surrounding fat and muscle tissues are carefully retracted to expose the lamina, which is then excised. This excision also involves the removal of the paired ligaments, known as the ligamentum flavum, that connect the laminae of adjacent vertebrae. The surgical team inspects the superior and inferior articular facets and the pars interarticularis, which are important for the stability and movement of the spine. The procedure includes exploring the openings beneath the facet joints where spinal nerves exit, and bone is removed as necessary to decompress these nerve roots. The spinal canal is thoroughly examined, and the intervertebral foramen is enlarged to relieve pressure on the spinal cord. Additionally, any adhesions between the dura mater and the ligamentum flavum are lysed to facilitate better access to the nerve structures. The spinal nerve roots and/or cauda equina are meticulously dissected and freed within the intervertebral foramen to ensure optimal recovery and function. Finally, the surgical wound is closed in layers to promote healing. This procedure can be performed unilaterally or bilaterally and is reported with specific CPT codes depending on the location of the surgery, with additional segments being reported separately using CPT® Code 63048.