# intradural vs extradural 61781 or 61782



## suzannereed (Aug 13, 2011)

The op report in questions states "...The scalp  flaps wre retracted with fishhooks, and the periosteum was dissected sharply and moved with periosteal elevators.  Navigation was again used to approximate the location of the turmor to fashion a craniotomy.  Four bur holes were made with the craniotome drill bit, and these were connected in a square-shaped fashions using a router bit.  After the bone flap was removed, the dura was irrigated and coagulated.  Next, dural tenting sutures were placed with 4-0 Nurolon suture, tenting the dural to the skull.  A #15 scalpel blade was then used to incise the dural with its base toward the sagittal sinus.... more can be provided if needed.  My question, is this...this would be 61510 with the new code 61781, not 61782.  Am I correct?  Any help would be appreciated.  Thanks in advance.


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## specialtycoder (Aug 16, 2011)

The surgeon states that the dura was incised and tacked back, so I would code this as intradural.


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## suzannereed (Aug 16, 2011)

Than you for your reply.  I just wanted to be sure. thanks again.


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## Fran Born (Oct 13, 2014)

*Intradural VS extradural*

So if they state the dura was coagulated, is that intradural also?


We then used an AM-8 drill to drill an entry point for the biopsy needle.  Dura was then coagulated using bipolar cautery.  Using the Vario guide we aligned the biopsy needle, made a single pass and biopsies done in 6 quadrants of the superior aspect of the tumor and then did a second pass and biopsied the inferior aspect of the tumor.  After this, frozen section came back as a neoplastic process for a potentially high-grade glioma.  We irrigated the wound with copious amounts of antibiotic saline, placed a piece of DuraGen and applied a bur hole cover and achieved closure in layers using 0-Vicryl for the fascia and subcutaneous tissue, and 3-0 nylon for the skin.


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