# Craniotomy coding



## icys@aol.com (Feb 4, 2014)

For 
temporal craniotomy, 
excision of extraaxial anterior temporal lesion, 
intraoperative ultrasound guidance

i chose 61510,61781,61321 do you think these are good codes? Any suggestions?


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## taparker (Feb 6, 2014)

I would only use 61510. 

61510 Description from Coder's Desk Reference: _The physician removes a supratentorial abscess or cyst. Supratentorial structures are those located above the tentorium cerebelli, the membrane that separates the cerebellum from the basal surface of the occipital and temporal lobes of the cerebrum. The physician incises and retracts the scalp and removes bone over the area of the tumor, meningioma, abscess, or cyst. The tumor, meningioma, abscess or cyst is identified and excised. The bone is replaced and stabilized. The scalp is anastomosed and sutured in layers. In 61510, the physician removes a brain tumor. In 61512, a meningioma is removed. A meningioma is a tumor of the lining of the brain. In 61514, an abscess is excised. In 61516, a cyst is excised or fenestrated. Fenestration is the surgical creation of an opening or window in the cyst to allow it to drain._


61781 is for stereotactic guidance. I only use 61781 when my surgeons use a neuro navigation system during the procedure._ Lay Description: The physician performs cranial or spinal procedures utilizing stereotactic computer-assisted navigation. These codes may only be assigned in conjunction with the primary procedure when the physician uses a computer to assist with coordinate determination established with a CT or MRI scan. Report 61781 for intradural cranial procedures_

 61321 wouldn't be needed as this is firstly the wrong location(infratentorial) and the excision of the lesion is fully covered by 61510.


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## cxowens (May 13, 2014)

I would look at code 61510.  I don't think you can bill for the ultra sound.
61781 is he used the navigation system
69990 if he used the microscope

I hope this helps.


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