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Laminectomy with cordotomy, as described by CPT® Code 63195, is a surgical procedure aimed at alleviating severe pain by selectively targeting the anterior spinothalamic tract, which is the primary pathway for pain transmission within the spinal cord. This procedure is particularly relevant for patients experiencing significant unilateral pain, often associated with malignancies in terminal stages. The anterior spinothalamic tract is located in the anterolateral aspect of the spinal cord and is responsible for conveying sensory information from the opposite side of the body to the brain. The laminectomy component involves the surgical removal of a portion of the lamina, which is the bony structure covering the spinal canal, to access the spinal cord. Cordotomy can be performed in a single operation or as part of a two-stage procedure, and it can be executed unilaterally or bilaterally, depending on the patient's specific pain management needs. Although advancements in pain management techniques have reduced the frequency of cordotomy procedures, they remain a critical option for patients suffering from intractable pain that cannot be managed through other means. The surgical approach begins with an incision over the targeted vertebra in the cervical or thoracic region, extending down to the spinous processes, followed by muscle retraction and lamina removal to expose the spinal cord for the precise identification and sectioning of the spinothalamic tract.
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The procedure of laminectomy with cordotomy (CPT® Code 63195) is indicated for patients experiencing severe unilateral pain, particularly in cases associated with malignancies in terminally ill patients. This procedure is typically considered when other pain management strategies have proven ineffective, and the goal is to provide relief from intractable pain that significantly impacts the patient's quality of life.
The laminectomy with cordotomy procedure involves several critical steps to ensure effective access to the spinal cord and the targeted spinothalamic tract.
Following the laminectomy with cordotomy, patients may require specific post-operative care to ensure proper recovery. This includes monitoring for any complications related to the surgery, such as infection or neurological deficits. Pain management will continue to be a focus, as the goal of the procedure is to provide relief from severe pain. Patients may also need rehabilitation services to aid in recovery and to help them regain strength and mobility. The expected recovery time can vary based on the individual patient's health status and the extent of the procedure performed.
| Short Descr | INCISE SPINE & CORD THORACIC | Medium Descr | LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT THORACIC | Long Descr | Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; thoracic | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1F - Major procedure - explor/decompr/excis disc | MUE | Not applicable/unspecified. | CCS Clinical Classification | 3 - Laminectomy, excision intervertebral disc |
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| 2021-12-31 | Deleted | Code deleted |
| 2013-01-01 | Note | Short Descriptor changed. |
| 2009-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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