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CPT®
63199

CPT® Code 63199
Deleted

Official Description

Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; thoracic

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 63199 refers to a laminectomy combined with a cordotomy, specifically targeting the anterior spinothalamic tracts in the thoracic region of the spinal cord. A laminectomy involves the surgical removal of a portion of the vertebral bone called the lamina, which allows access to the spinal cord. The primary goal of this procedure is to selectively destroy the spinothalamic tracts, which are responsible for transmitting pain sensations from the body to the brain. This procedure can be performed in two stages within a 14-day period, allowing for a more controlled approach to managing severe pain, particularly in terminally ill patients suffering from malignancies. The anterior spinothalamic tract is located bilaterally in the anterolateral aspect of the spinal cord, and its destruction can significantly alleviate unilateral pain. Although the use of cordotomy has diminished with the introduction of newer pain management techniques, it remains a viable option for patients experiencing intractable pain that is not responsive to other treatments. The surgical approach involves making an incision over the targeted vertebra, retracting the muscles, and using a bone drill to expose the spinal cord for the precise identification and sectioning of the spinothalamic tracts.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 63199 is indicated for patients experiencing severe unilateral pain, particularly due to malignancy in terminally ill individuals. This pain is often resistant to conventional pain management therapies, making a cordotomy a potential option for symptom relief. The procedure is specifically aimed at patients who may benefit from the selective destruction of the anterior spinothalamic tract, which is the primary pathway for pain transmission in the spinal cord.

  • Severe Unilateral Pain This procedure is primarily indicated for patients suffering from severe unilateral pain, often associated with malignancies.
  • Terminal Illness It is particularly relevant for terminally ill patients who may not respond to other pain management strategies.

2. Procedure

The procedure involves several critical steps to ensure the effective execution of the laminectomy and cordotomy. Each step is designed to provide access to the spinal cord and facilitate the precise destruction of the spinothalamic tracts.

  • Step 1: Incision The surgical process begins with an incision made over the vertebra in the cervical or thoracic spine, depending on the specific location of the pain. This incision is carefully extended down to the spinous processes to provide adequate access to the underlying structures.
  • Step 2: Muscle Retraction Once the incision is made, the surrounding muscles are retracted away from the lamina and facet joint. This retraction is crucial for exposing the bony structures of the spine without causing unnecessary damage to the muscle tissue.
  • Step 3: Laminectomy A bone drill is then utilized to remove part or all of the lamina, which is the bony arch of the vertebra. This step is essential for exposing the spinal cord and the targeted spinothalamic tracts.
  • Step 4: Identification and Sectioning of the Spinothalamic Tract With the spinal cord now exposed, the surgeon identifies the spinothalamic tract. This tract is then carefully cut to achieve the desired effect of pain relief. The precision in this step is vital to ensure that only the intended pathways are affected.

3. Post-Procedure

After the completion of the procedure, patients are typically monitored for any immediate complications related to the surgery. Post-operative care may include pain management strategies to address any discomfort following the procedure. Recovery expectations can vary, but patients may experience significant relief from pain as the effects of the cordotomy take hold. Follow-up appointments are essential to assess the effectiveness of the procedure and to monitor for any potential complications or side effects. It is important for healthcare providers to provide thorough instructions regarding activity restrictions and signs of complications that patients should be aware of during their recovery period.
Short Descr INCISE SPIN&CORD 2 STGS THRC
Medium Descr LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES THORACIC
Long Descr Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; 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) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 3 - Laminectomy, excision intervertebral disc
Date
Action
Notes
2021-12-31 Deleted Code deleted
2013-01-01 Changed Short Descriptor changed.
2009-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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