May 25, 2023 Question: The neurosurgeon documents a placing a cervical “facet implant or intrafacet implant “ with bone graft. Is this coded as 22600, cervical arthrodesis? Answer: No. This is coded with a Category III code, as shown below: Facet Wedge or Dowel Arthrodesis (Intrafacet Implant) Placement of a posterior intrafacet implant(s), unilateral or...
May 11, 2023 Question: The surgeon placed methylmethacrylate around the pedicle screw in a spine surgery. How is this coded? Answer: Placing methylmethacrylate to reinforce the instrumentation is included in the spine procedure. *This response is based on the best information available as of 05/11/23.
April 27, 2023 Question: When using LITT treatment, can the neuronavigation and headframe placement be billed separately? Answer: No, neuronavigation, 61781 and headframe placement, 20660 are included and may not be billed separately. *This response is based on the best information available as of 04/27/23.
April 13, 2023 Question: I’m using LITT for epilepsy treatment. Answer: The codes are 61736 Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion and 61737 multiple trajectories for multiple or complex lesion(s) *This response is based on the best...
March 30, 2023 Question: I just got a case where the neurosurgeon and ENT want to bill the following codes: ENT, 61596, Transcochlear posterior fossa skull base code for the approach. Neurosurgeon, 61616, intradural resection of a posterior fossa skull base tumor Is this correct? The diagnosis is a right translabyrinthine approach to cerebellopontine angle...
March 16, 2023 Question: Is there a code for a craniotomy for decompression for Chiari? And the surgeon also did a C1 laminectomy. Is that a separate code? Answer: The code for a decompressive craniotomy for Chiari is 61343 and includes the work of the cervical laminectomy. *This response is based on the best information...
March 2, 2023 Question: Can placement of a lumber drain be billed separately with a cranial procedure? I heard that placing drains is not billable. Answer: You are correct that placement of a drain in the surgical site/exposure is not separately billable. Placing a lumber drain via a separate incision ( in the back) during...
February 16, 2023 Question: The patient present with a ruptured aneurysm. A craniotomy was performed to clip the aneurysm and the hematoma was evacuated to access the aneurysm. Are both the aneurysm clipping and the hematoma evacuation billable? Answer: No, the aneurysm codes are valued for ruptured or non- ruptured aneurysms and evacuating the hematoma...
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...
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...
