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Anesthesia Coding Alert

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Moyamoya Procedure Calls for Unlisted Procedure Code

Published on Mon May 18, 2009

Question: What is the correct code for a procedure called an "encephaloduroarteriosynangiosis"? New Mexico Subscriber Answer: Encephaloduroarteriosynangiosis (EDAS) is a neurosurgical procedure involving the placement of a superficial temporal artery (an artery in the scalp) on the dura (firm covering of the brain). The purpose is to revascularize an ischemic portion of the brain. It is used in the treatment of 437.5 (Moyamoya disease). The closest CPT code to describe this procedure is 61711 (Anastomosis, arterial, extracranial-intracranial [e.g., middle cerebral/ cortical] arteries), but EDAS does not include anastomosis. Best bet: Choose the unlisted anesthesia code for brain surgery: 00210 (Anesthesia for intracranial procedures; not otherwise specified). You might be tempted to use 00216 (Anesthesia for intracranial procedures; vascular procedures), but the temporal artery is not an intracranial vessel. It is in an intracranial location, so the procedure is intracranial.
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