Anesthesia Coding Alert

Question: What code should we report for anesthesia during facet joint rhizotomy?

Kentucky Subscriber

Answer: The CPT^® 2020 code book includes two codes for rhizotomy: 63185 (Laminectomy with rhizotomy; 1 or 2 segments) and 63190 (… more than 2 segments). Correct coding depends on the number of segments involved rather than the spinal region treated.

If the surgeon reports 63185, the primary anesthesia code is 00600 (Anesthesia for procedures on cervical spine and cord; not otherwise specified), which carries 10 base units. Other alternate anesthesia codes include:

• 00604 (Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position)
• 00620 (Anesthesia for procedures on thoracic spine and cord, not otherwise specified)
• 00630 (Anesthesia for procedures in lumbar region; not otherwise specified)
• 00670 (Anesthesia for extensive spine and spinal cord procedures [(eg, spinal instrumentation or vascular procedures)

Select the most applicable, highest-base code for your claim.

If code 63190 applies, it crosses to anesthesia code 00670, with 13 base units.

Note: Rhizotomy is a surgical procedure that involves the cutting of nerve roots in the spinal cord to relive the symptoms of neuromuscular conditions, such as chronic back pain and muscle spasms. The procedure is performed through laminotomy or laminectomy and is performed under general anesthesia.