Neurology & Pain Management Coding Alert

Question: What are the correct surgical and anesthesia codes for facet rhizotomy? 

Tennessee Subscriber 

Answer: Rhizotomy is a surgical procedure to sever nerve roots in the spine as a way to relieve chronic back pain and muscle spasms. CPT® currently includes two code choices 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. 

Take note: Pain management specialists rarely perform a traditional rhizotomy procedure (neurosurgeons and orthopedists typically perform it). Because of this, you probably only need to report the procedure’s anesthesia that your specialist provides. 

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. Code 63190 crosses to anesthesia code 00670 (Anesthesia for extensive spine and spinal cord procedures [eg, spinal instrumentation or vascular procedures]) 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. The procedure is performed through laminotomy or laminectomy and is performed under general anesthesia.