March 30, 2017

Question:
I’m confused.  Should I use 61548 vs 61580 & 61600 to bill an endoscopic transnasal approach to remove a pituitary tumor?  Or is this an unlisted code (64999)?

Answer:
Good question – there are actually 3 CPT codes that specifically address removal of a pituitary tumor none of which are the skull base surgery codes you asked about (61580 & 61600).  They are listed in the table below:

CPT Code	CPT Descriptor	Approach
61546	Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach	Craniotomy, open
61548	Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic	Transnasal or transseptal using a microscope
62165	Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach	Transnasal or trans-sphenoidal using an endoscope

The codes, 61580 and 61600, are skull base codes which require an open approach and are not used to report transnasal procedures.

So there is a code for the procedure you describe and that is 62165.  Remember to append modifier 62 (two surgeons) if the approach is performed by the otolaryngologist (both surgeons report 62165-62).

*This response is based on the best information available as of 03/30/17.