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Neurosurgery Coding Alert

Part 1:
Carefully Applying Codes and Modifiers Eases Payment for Facet Joint Injections
Recent Medicare and CPT revisions have increased confusion for physicians administer... Read more
Medicare Update:
Retroactive Revisions Could Increase Your Payments
A recent Medicare policy decision could allow you to collect additional reimbursemen... Read more
Solve the Ommaya Reservoir Mystery
CPT and CMS offer conflicting views regarding the placement of an Ommaya reservo... Read more
News Brief:
Look for Revised Place-of-Service Indicators in 2003
As part of CMS' proposed revisions to the 2003 Physician Fee Schedule, the agency ha... Read more
Reader Questions:
Decompression With Bone Graft
Question: How should I report decompression by laminectomy at L4/L5, posterior lum... Read more
Reader Questions:
Multilevel Decompression
Question: In cases of multilevel lumbar decompressions, Medicare pays for 63047 and on... Read more
Reader Questions:
Syrinx Diagnosis
Question: Our physician assigned a diagnosis of "syrinx C2-T8." How should I code this... Read more
Reader Questions:
Retroperitoneal Schwannoma Removal
Question: How should I report a retroperitoneal approach and resection of an L3/L4 sch... Read more
Reader Questions:
Team Surgery
Question: Are there any special requirements for appending modifier -66? Maine Subscr... Read more
Reader Questions:
Billing for Treatment to Relatives
Question: Recently, our neurosurgery practice began treating an aunt of one of the gro... Read more
You be the Coder:
Arthrodesis and Separate Decompression
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Massive CCI Version 8.3 Brings Revision for Neurosurgery Practice
CMS, along with the National Technical Information Service (NTIS), has released vers... Read more
Reimbursement Is Knocking:
Coding Open-Door Laminoplasty
Open-door laminoplasty is a unique neurosurgical procedure for which there is no ded... Read more
Don't Overlook Codes for Fluoroscopic Imaging
Neurosurgeons use fluoroscopic imaging for a variety of surgical and d... Read more
Thorough Diagnosis Coding Boosts E/M Reimbursement
Coexisting conditions influence an E/M service's basic components (history, exam and... Read more
READER QUESTION:
Pain Dx
Question: My physician often claims "chronic pain" as a diagnosis, but I can find no... Read more
READER QUESTION:
Intraoperative Ultrasound
Question: Our surgeon used ultrasound localization during a posterior fossa craniect... Read more
READER QUESTION:
CSF Leak
Question: I have a denial from a private insurance carrier saying cerebrospinal flui... Read more
READER QUESTION:
Silastic Graft
Question: What is the appropriate code to report silastic dural expansion graft foll... Read more
READER QUESTION:
Redo Procedure
Question: A Medicare patient had an evacuation of a subdural hematoma (61154). Twent... Read more
You Be the Coder:
Stealth Navigation System
 Test your coding knowledge. Determine how you would code this situation ... Read more
Differentiate Laminectomies and Laminotomies for Optimum Results
Laminectomies and laminotomies are distinct procedures, but the similarities bet... Read more
How to Distinguish Assistant at SurgeryModifiers
Neurosurgeons often employ surgical assistants in the operating room, but with thr... Read more
ICD-9 Update:
ICD-9 Update:
Prepare Now for 2003 Revisions Although the New Year is still months away, some pay... Read more
Correction:
Multiple Surgeons and Spinal Instrumentation
The May 2002 Neurosurgery Coding Alert erroneously reported that two surgeons working ... Read more
Reader Question:
Deep Brain Stimulators
Question: What is the proper coding for implantation and programming of deep bra... Read more
Reader Question:
Segmental Instrumentation
Question: Our surgeon performed segmental spinal stabilization using axis plate at C... Read more
Reader Question:
RNFA Surgical Assist
Question: Our office employs an RN who assists our neurosurgeon with surgical proced... Read more
You Be the Coder:
Microlaser Diskectomies
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Narrow the Search for the Appropriate Intracranial Aneurysm Surgery Codes
CPT includes 15 codes to describe surgeries for intracranial aneurysms, arterio-v... Read more
Correction:
Anterior Arthrodesis
The February 2002 Neurosurgery Coding Alert (page 9) incorrectly stated that during an... Read more
Two Surgeons,One Surgery:
Optimal Use for Modifier -62
Coding can become tricky when two surgeons work together during the same surgery. Medicare... Read more
News Brief:
CMS Considers National Coverage for Bilateral Subthalamic Nucleus Stimulation
CMS is considering a national coverage determination for bilateral deep brain stimulat... Read more
Reader Question:
Consult or Referral?
Question: On occasion, a patient with radicular pain and an MRI with positive findings... Read more
Reader Question:
Arthrodesis and Laminectomy
Question: Our local carrier is not reimbursing 22630 when reported with 63047. How sho... Read more
Reader Question:
E Codes
Question: What are "E" codes and when should they be used? Tennessee Subscriber A... Read more
Reader Question:
RegionalLesion Removal
Question: Recently, our surgeon performed a laminectomy for removal of intraspinal l... Read more
You Be the Coder:
Fluoroscopic Guidance
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Have the Nerve to Report 64855-64902 for Optimal Results
Along with the usual concerns of properly reporting multiple procedures and avoiding b... Read more
Be Precise:
Complete ICD-9 Coding Protects Reimbursement
Busy physicians sometimes fail to indicate pertinent information in the medical record... Read more
Applicable Nerve Graft CPT Codes
64885 Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ... Read more
The Tick-Tock of the Clock Could Lead to Higher Payment
Lengthy but low-level E/M visits or time spent reassuring and counseling patients in t... Read more
CCI Update:
No News Is Good News for Version 8.2
National Technical Information Services (NTIS) has released version 8.2 of the nationa... Read more
News Brief:
No More E/M Documentation Guidelines?
Recently, the AMA announced on its Web site that on May 16, Health and Human Services ... Read more
Reader Question:
Reporting Re-Explorations
Question: The neurosurgeon performs a re-exploration microdiskectomy at level L4-5 (un... Read more
Reader Question:
Gamma Knife
Question: Which is the proper code to report use of a gamma knife during surgery? Tex... Read more
Reader Question:
Diagnoses to Support Critical Care
Question: I'm confused by the Medicare instructions recommending that a diagnosis fr... Read more
Reader Question:
Unlisted Procedures
Question: If I want to report a certain procedure for which CPT does not include a s... Read more
You Be the Coder:
Failed Surgery
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Pump Up Reimbursement:
Prove Necessity to Get Pain Pump Claims Paid
Although pain pumps can alleviate a patient's postsurgical discomfort, some insurers... Read more
Pain Pumps:
Dont Forget to Bill for Supplies
If a neurosurgeon supplies the pump and catheter for the implantation (or subsequent r... Read more
Tips and Guidelines for Successfully Billing Consults
Determining what constitutes a consultation as opposed to a referral or transfer ... Read more
News Brief:
AMA Accepts Request to Develop Code for Gliadel Wafers
As reported in the April 2002 Neurosurgery Coding Alert, coding for placement of Gliad... Read more
Reader Question:
Fusion Removal and Reconstruction
Question: Recently, I reported a surgery as follows: 22558 22851 22855 The insur... Read more
Reader Question:
Deep Brain Stimulation
Question: What codes are appropriate for the markers, stereotactic frame, burr hole, i... Read more
You Be the Coder:
Professional Component-Only Services
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Harvest Proper Reimbursement When Reporting Graft Procedures
Reporting graft procedures can be complicated for several reasons. Coders must k... Read more
Dont Underuse 99291-99292:
You May Be Losing Money
Many neurosurgeons provide critical care but don't report the services as such because... Read more
Code Separately Reportable Services With Critical Care
According to CPT, critical care codes 99291 (Critical care, evaluation and managemen... Read more
Reader Question:
Subcutaneous Reservoir
Question: What is the proper code to report removal of a subcutaneous reservoir? Virg... Read more
Reader Question:
61510 and 61312
Question: When I report 61510 and 61312 together, my claims are denied. What am I doin... Read more
Reader Question:
Stereotactic Brachytherapy
Question: How should I report stereotactic brachytherapy? Massachusetts Subscriber A... Read more
You Be the Coder:
Billing Supplies: Halo Screws
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Receive Proper Reimbursement for Spinal Instrumentation Procedures
" Coding for placement of spinal instrumentation can be complicated by several factors, ... Read more
CCI Update:
Version 8.1 Brings Minor Changes for Neurosurgery
Version 8.1 of the national Correct Coding Initiative (CCI) is available and remains a... Read more
Helpful Hints:
Access to Carrier Policies Is Only a ClickAway
Every coder knows the frustration of dealing with multiple insurers, each with its own... Read more
Reader Question:
Stereotactic Biopsy
Question: We've been receiving denials for 61751 with 61510 and +61795 because accord... Read more
Reader Question:
Reporting Endoscope
Question: How should I code for use of an endoscope during a neurosurgical procedure? ... Read more
Reader Question:
Redo Laminectomies
Question: In reference to "redo" coding, are the following codes appropriate? L3 th... Read more
You Be the Coder:
Colloid Cyst
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
More Solutions for Reporting Common Postoperative Complications
On occasion, patients who have undergone neurosurgical spinal procedures will experi... Read more
Get Paid for Preoperative Exams with Modifier -57
Medicare guidelines stipulate that E/M services provided the day before or the day of a ... Read more
Reader Question:
Neurostimulator Placement
Question: I notice that the descriptors for 64555 and 64575 have changed for 2002. How wil... Read more
Reader Question:
Professional Component
Question: What are the guidelines for reporting professional services?South Dakota Subsc... Read more
Reader Question:
Gliadel Wafer Implant
Question: When a physician performs a craniotomy for tumor removal and inserts Gliadel w... Read more
You Be the Coder:
Epidural Steroid Injection
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Simple Solutions for Reporting Common Postoperative Complications
Patients undergoing complex and delicate neurosurgical procedures are prone to postope... Read more
Prolonged Services Are for Extra Time Spent Face-to-Face
Physicians and coders are reluctant to report prolonged services codes (99354-99357) b... Read more
News Brief:
Payment Conversion Factor Lowered for 2002
Due to congressional mandates to lower overall Medicare spending, the national average phy... Read more
Reader Question:
Craniotomy, Resection and Duraplasty
Question: The surgeon performed a right parietal craniotomy with gross total resection o... Read more
Reader Question:
Documentation Requirements
Question: Is a physician required to sign and date dictation (office notes) if a transcrib... Read more
Reader Question:
Associated Procedures
Question: May we report the fracture repair codes in addition to a vertebral corpectomy?... Read more
You Be the Coder:
Percutaneous Diskectomy
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Reporting ACDF:
Step-by-Step Instructions to Get Your Claims in Order
" Anterior cervical diskectomy with fusion (ACDF) can be a challenge to code correctly bec... Read more
Get Preauthorization, Append Modifiers When Billing for PAs
Neurosurgeons undertaking time-intensive procedures can often benefit from a physician a... Read more
CCI Update:
Version 8.0 Effective Jan. 1
Version 8.0 of the national Correct Coding Initiative (CCI) went into effect Jan. 1, 2002,... Read more
Reader Question:
Intrathecal Baclofen
Question: How should I report administration of intrathecal baclofen?Arizona Subscriber ... Read more
Reader Question:
Kyphoplasty
Question: Which code(s) are used for kyphoplasty?Michigan Subscriber  Answer: Kyphop... Read more
Reader Question:
Ventricular Decompression
Question: Is it appropriate to report 61107 or 61210 for placement of a ventricular drain ... Read more
Reader Question:
Lumbar Decompression and Microdiskectomy
Question: What is the proper coding for a bilateral lumbar decompression (L4 and L5) with ... Read more
You Be the Coder:
Ultrasound with Craniotomy
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Follow CPT Guidelines To Report Multilevel Spinal Surgeries Properly
CPT codes are written to reflect current medical practices, which do not always lend the... Read more
Use It, Dont Abuse It:
When To Append Modifier -59
Modifier -59 (distinct procedural service) is important because it enables neurosurgeo... Read more
Anthrax Coding Report Free on Web
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Reader Question:
Craniectomy With Fenestrations
Question: A neurosurgeon performed a bilateral craniectomy with fenestration of septum pel... Read more
Reader Question:
Discontinued Surgery
Question: During surgery to remove an aneurysm, the patient developed uncontrolled bleedin... Read more
Reader Question:
Mini-Mental Exams
Question: Does Medicare reimburse for mini-mental exams? If the service is part of an E/M,... Read more
Reader Question:
Imaging and Biopsy
Question: How should I code a stereotactic craniotomy with application of a headframe, MRI... Read more
You Be the Coder:
Two Surgeons, Multiple Procedures
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Available Years:  2002  2001  2000