# Repair CSF leak with pedicled flap



## janjones (Feb 24, 2010)

ENT did a transnasal endoscopic approach and resection of pituitary tumor, repair of cerebrospinal fluid leak with abdominal fat graft and pedicled vascularize nasal septal flap.  The surgeon wants to code 62165, 61619 and 61795.  I'm concerned billing 61619 because CPT states it's for a secondary repair.  I appreciate all suggestions and thoughts.
Thank you, Jan


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## tlivengo (Jun 28, 2010)

I know this is a really old post but interesting because I am wondering the exact same thing, and sad to see there's no responses  

My ENT providers do the endoscopic pituitary resections as co-surgeries with Neurosurgeons and we bill 62165-62 and the NS does the harvest of the abdominal graft and then the ENT does the packing of the fat graft.  HOWEVER, the NS gets the whole 20926 code and ENT nothing for packing it, even though it says in the Coding Companion that the application of the graft should be coded separately.   That's why I was considering code 61618 but that doesn't really work since it's belongs with the skull base codes and it is not endoscopic.  So if anyone sees this somehow, I would appreciate any tips on a possible code for the closing portion of the surgery.

Thanks!


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## akbookworm (Nov 25, 2015)

Try using 61291 if its the endoscopic approach


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