Category: CC-Neurosurgery

E&M Coding Based on Time
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E&M Coding Based on Time

January 19, 2023 Question: When choosing the level of E&M we are confused about the History and Exam. If we choose a level of E&M based on time, does this time count toward total time, or is it only time spent on MDM? Answer: When choosing a level of E&M based on time, CPT identifies...

Counting Laminectomy Levels
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Counting Laminectomy Levels

December 15, 2022 Question: I am confused and hoping you can clarify a coding question I have. I thought I understood how to report laminectomy levels, however, after recently reading an article in the AHA Coding Clinic HCPCS Volume 22, Number 2 Second Quarter 2022 publication, I doubt myself. The surgeon performs and documents a...

Foreign Body Removal
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Foreign Body Removal

December 1, 2022 Question: A patient had a craniotomy a week ago and the provider is doing a removal of a retain drain of post op wound in the operating room. What is the best code to use 10120? Answer: The best code is 10121, incision and drainage of foreign body, complex, since this required...

Counting Laminectomy Levels
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Counting Laminectomy Levels

November 17, 2022 Question: I am confused and hoping you can clarify a coding question I have. I thought I understood how to report laminectomy levels, however, after recently reading an article in the AHA Coding Clinic HCPCS Volume 22, Number 2 Second Quarter 2022 publication, I doubt myself. The surgeon performs and documents a...

Coding for Trigeminal Neuralgia #3
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Coding for Trigeminal Neuralgia #3

November 3, 2022 Question: How is RFA rhizotomy of the trigeminal nerve at the second and third division branches of the foramen ovale reported? The diagnosis was Trigeminal Neuralgia. Answer: This procedure is coded as 64605, Destruction by neurolytic agent, trigeminal nerve second and third division branches at foramen ovale. Code +77002 may also be reported if fluoroscopy is...

Coding for Trigeminal Neuralgia #2
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Coding for Trigeminal Neuralgia #2

October 20, 2022 Question: How is percutaneous ganglion balloon compression rhizotomy of the trigeminal nerve reported? The diagnosis was Trigeminal Neuralgia. Answer: This procedure is reported with an unlisted code, 64999. There is no CPT code for this percutaneous procedure. *This response is based on the best information available as of 10/20/22.      

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...

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