Category: Neurosurgery

Facet Fusion
Post

Facet Fusion

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...

Laser Interstitial Thermal Therapy (LITT) Coding
Post

Laser Interstitial Thermal Therapy (LITT) Coding

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...

CP Angle vs Skull Base Codes
Post

CP Angle vs Skull Base Codes

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...

Coding for a Chiari Malformation
Post

Coding for a Chiari Malformation

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...

Lumbar Drain in a Cranial Procedure
Post

Lumbar Drain in a Cranial Procedure

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...

Ruptured Aneurysm and a Hematoma
Post

Ruptured Aneurysm and a Hematoma

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...

E&M Coding Based on Time
Post

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
Post

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...

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches