Summary & Overview
CPT 63282: Laminectomy and Excision of Intradural Extramedullary Spinal Lesion
CPT code 63282 identifies a neurosurgical procedure involving laminectomy of the lumbar vertebra and excision of an intradural, extramedullary spinal lesion with tissue sent for pathology. This code captures a complex operative service that often requires an operating room, neurosurgical specialization, and perioperative inpatient care. Nationally, accurate coding for such procedures affects hospital billing, resource allocation, and quality measurement for spinal tumor management.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, common billing and documentation considerations, and clinical context relevant to surgical management of intradural, extramedullary lesions.
Readers will learn how CPT code 63282 is defined clinically, typical sites of service, and what benchmark metrics and policy updates are most relevant for this service line. The report summarizes common modifiers used with major payers, highlights documentation elements tied to reimbursement and medical necessity, and provides context for coordination between neurosurgery, pathology, and inpatient services. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 63282 describes a surgical procedure in which a portion of a lumbar vertebra called the lamina is removed (laminectomy) and an intradural, extramedullary lesion adjacent to the spinal cord is excised, with a portion of the lesion sent for pathological testing. Intradural indicates the lesion is inside the dura mater, the tough outer membrane surrounding the central nervous system; extramedullary indicates the lesion lies outside the spinal cord itself.
Service Type: Surgical excision of intradural, extramedullary spinal lesion with laminectomy and tissue sampling
Typical Site of Service: Hospital operating room or inpatient surgical setting, often with perioperative inpatient care due to the invasive nature and need for neurosurgical monitoring.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45–65-year-old adult presenting with progressive low back pain, unilateral or bilateral radiculopathy, sensory changes, and possible motor weakness referable to a lumbar intradural, extramedullary lesion (for example, a schwannoma or meningioma). Imaging with MRI of the lumbar spine demonstrates a well-circumscribed intradural, extramedullary mass at a specific lumbar level with mass effect on the cauda equina. The clinical workflow begins with neurosurgical evaluation, preoperative clearance, and informed consent for laminectomy and intradural tumor resection. On the day of service the patient is brought to the operating room, placed under general anesthesia, and positioned for a lumbar posterior approach. The surgeon performs a partial or complete laminectomy of the involved vertebra (lamina removal) to expose the dura, opens the dura, microsurgically dissects and excises the intradural, extramedullary lesion, and sends a specimen for pathologic analysis. Hemostasis is achieved, the dura is closed (with or without graft), and standard multilayer closure is performed. Postoperative course includes monitoring in PACU or ICU as indicated, pain control, neurologic checks, and inpatient observation for 1–3 days, with follow-up for pathology results and rehabilitation as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons perform distinct parts of the procedure concurrently (co-surgery) during complex intradural tumor resection. |