Category: CC-Neurosurgery

Coding for Trigeminal Neuralgia #1
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Coding for Trigeminal Neuralgia #1

October 6, 2022 Question: A retrosigmoid craniotomy was performed with microvascular decompression of the 5th nerve. The diagnosis was Trigeminal Neuralgia. How is this coded? Answer: This procedure is reported with code 61458, Craniotomy, suboccipital, for exploration or decompression of cranial nerves. *This response is based on the best information available as of 10/06/22.  ...

Coding a Decompressive Craniectomy
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Coding a Decompressive Craniectomy

September 22, 2022 Question: In a recent head trauma case, a decompressive craniectomy was performed with a partial temporal lobectomy, due to extensive damage. A hematoma was also evacuated. can we bill for the 61323 decompressive craniectomy code with lobectomy since only a partial lobectomy was done? And what about cooing for the hematoma evacuation?...

Billing for Costotransversectomy
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Billing for Costotransversectomy

August 25, 2022 Question: If the exposure is thoracic, for example in a thoracic corpectomy, and the documentation states a costotransversectomy was performed, can that be billed separately? Answer: Costotransversectomy (e.g., 21610) is included in a thoracic corpectomy and not separately billed. Note also that 21610 states “separate procedure” so it is never billed with...

Coding for Spine Procedures that Cross Spinal Junctions
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Coding for Spine Procedures that Cross Spinal Junctions

August 11, 2022 Question: How do you report a spinal procedure for example, arthrodesis or laminectomies when two spinal are involved. For example., both thoracic and lumbar spine? Answer: Report one stand-alone/primary code even when the procedure crosses spine junctional levels. Use the stand-alone code for the spine region where the majority of the procedure/levels...

Removal of Interbody Device
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Removal of Interbody Device

July 28, 2022 Question: Can code 20680, removal of implant, be used for removal of a previously placed intervertebral device, such as a PEEK cage? Answer: No. There is no code for removal of an intervertebral device – this would be part of an exploration of arthrodesis or new arthrodesis, if performed. Do not use...

Coding for Percutaneous Screws and Rod Placement
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Coding for Percutaneous Screws and Rod Placement

July 14, 2022 Question: I placed posterior percutaneous screws and rods without an arthrodesis. I know I have to use an unlisted code, 22899. How should I price it? Answer: Good question. Let’s assume you’re doing +22842 (posterior instrumentation, 3-6 segments) which is an add-on code. Add-on codes are valued for only the intra-operative portion...

Billing Additional Pre-op Visit
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Billing Additional Pre-op Visit

June 2, 2022 Question: Since we have to bring the patients back in for COVID testing and H&P for Joint Commission, can we bill for this visit even though it’s another pre-op visit? Answer: Yes, since the original surgery was canceled and is now under consideration for rescheduling due to the pandemic and needs to...

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