Advanced Search

Neurosurgery Coding Alert

CPT Update:
3 Long-Awaited Codes Solve Your Kyphoplasty Dilemmas
2006 changes save you from using another unlisted-procedure codeAfter years of waiting, yo... Read more
CPT Update:
Reporting Follow-up Consultations? Not Anymore
CPT 2006 deletes 99261-99263 and 99271-99275If your neurosurgeon provides consultations, t... Read more
CPT Update:
2 New Incision and Drainage Codes Fill a Coding Gap
Reviewed May 26, 2015 You'll no longer have to rely solely on 10180 You ca... Read more
CPT Update:
New Status Exam Code Offers Renewed Hope for Payment
Mini-mental exams remain a component of E/M servicesFor neurosurgeons who have tried to ga... Read more
READER QUESTIONS:
You Need a '1' Indicator to Unbundle NCCI
Question: How do I know whether I can -unbundle- NCCI edits?Georgia Subscriber Answer: Ea... Read more
READER QUESTIONS:
Look at the Harvesting for 38220 and 20937, 20938
Question: Can 38220 be reported with 20937 or 20938 when both the graft and the bone marro... Read more
READER QUESTIONS:
Use 22840 for Single-Level Instrumentation
Question: My doctor performed a bilateral hemilaminectomy with diskectomy and foraminotomy... Read more
READER QUESTIONS:
Report 63267 for Stenosis That's Independent From Abscess
Question: Can I only report 63267 once? What if the patient had a synovial cyst at L3 and ... Read more
You Be the Coder:
Solidify Your Allograft Coding
Question: The doctor uses what he describes as a -fibular allograft bone plug or bone spac... Read more
NCCI 11.3 Update:
Watch for Changes to Nerve Block Bundles
You'll soon be able to report E/M services with stereotactic radiosurgeryThe latest Nation... Read more
Get the Lowdown on the ABCs of ABNs
An advance beneficiary notice (ABN) is a written notice to a Medicare beneficiary that Med... Read more
22 Who? 3 Case Studies Illustrate Proper Application
You can include 'complicating' diagnoses to support 'unusual' claimModifier 22 can be a po... Read more
You Don't Have to 'Write Off' Noncovered Procedures
Why modifiers and a signed ABN can make the differenceIf you don't want to get caught abso... Read more
READER QUESTIONS:
Confirm Spinal Block Location for Fluoro Code
Question: Can I report fluoroscopy in conjunction with pain management blocks? If so, what... Read more
READER QUESTIONS:
Include Halo Adjustments in Post-Op Care
Question: How can we code for adjusting a cervical halo without using anesthesia?Indiana S... Read more
READER QUESTIONS:
Check Fixation Points for Instrumentation Type
Question: How can I distinguish segmental from non-segmental instrumentation?Pennsylvania ... Read more
READER QUESTIONS:
21 Provides an Alternative to Prolonged Services
Question: I-ve often been tempted to report modifier 21, but I-m unsure of the requirement... Read more
READER QUESTIONS:
Category lll Codes Describe IDEA
Question: Should we use an unlisted-procedure code to report IDEA?Missouri Subscriber Ans... Read more
You Be the Coder:
Defining Spinal Levels and Interspaces
Question: When coding for a posterior cervical or lumbar fusion of just two vertebrae, how... Read more
New Guidance Codes, Revised Descriptor Ease Denervation Claims for 2006
You can choose only one guidance procedure per claim If your neurosurgery practice perfor... Read more
More Chemodenervation Codes Join CPT in 2006
You-ll have to turn to modifier 52 for unilateral injections Rumors suggest that CPT 2006... Read more
4 Rules to Get Your Inpatient Consults Right
Choose one initial consult per inpatient stay Just because your surgeon meets with a pati... Read more
Billing a Consult? Be Sure to Document These 3 Points
Before reporting consult services 99241-99263, your documentation must show that the servi... Read more
CPT Streamlines Consult Coding for 2006
You-ll probably call on office E/M codes for -second opinions- The AMA has decided to del... Read more
Reader Questions:
Late Effects Are Secondary
Question: How should I apply late effects codes? For instance, what primary diagnosis shou... Read more
Reader Questions:
Look to Spinal Tap for Lumbar Drain
Question: I can't find a code in CPT to describe placement of a lumbar drain. Should I use... Read more
Reader Questions:
Never Pass up a Legitimate Consult
Question: The hospital asked my on-call surgeon to admit a patient. He spent an hour with ... Read more
Reader Questions:
'Open Door' = Cervical Laminoplasty
Question: What is -open-door laminoplasty,- and how should I code for it?Texas Subscriber ... Read more
You Be the Coder:
Do Bilateral Laminotomies Call for Add-on?
Question: Our surgeon performed right laminotomy at L4/L5 and left laminotomy at L2/L3. I ... Read more
Dispel 3 Spine Coding Myths at the Root of Reduced Reimbursement
Good news:  You can report instrumentation removal during repeat fusionsA surgeon per... Read more
Combine Excision and Evacuation (Most of the Time)
Use location modifiers to help to differentiate surgical sitesWhen your surgeon performs b... Read more
Purge Your Prejudice Against ICD-9 V Codes
V codes can provide diagnostic info. for non-acute conditionsIf your neurosurgery practice... Read more
READER QUESTIONS:
Don't Forget 24 With Critical Care
Question: My local Medicare payer has recently started denying critical care services, say... Read more
READER QUESTIONS:
Obesity May Complicate Spine Surgery
Question: Recently, our surgeon performed spinal fusion (22630) on an extremely obese pati... Read more
READER QUESTIONS:
Multiple Grafts Are Allowable
Question: Can we bill separately for multiple bone grafts during a single session? For exa... Read more
READER QUESTIONS:
Pituitary Resection Calls for Co-Surgeons
Question: Our surgeon is scheduled to perform endoscopic resection of a pituitary tumor. A... Read more
READER QUESTIONS:
Medicare May Not Pay for Certain Bone Grafts
Question: Are bone graft procedures 20930 and 20936 bundled with arthrodesis procedures 22... Read more
READER QUESTONS:
Shunt Tap Calls for Puncture Code
Question: How should I code for a shunt tap?Nebraska Subscriber Answer: For a shunt tap, ... Read more
READER QUESTIONS:
You Supply Evidence for Unlisted Procedure Pay
Question: How do insurers determine reimbursement when you report an unlisted procedure co... Read more
You Be the Coder:
Is Ultrasound OK With Craniotomy?
Question: May we report ultrasound guidance in addition to craniotomy? Michigan Subscriber... Read more
Look to New Category III T Codes for Artificial Disk Procedures
Continue to treat decompression as a separate procedureYou now have nine new codes to choo... Read more
What's the Purpose of Category III Codes?
When a category III code exists to describe a service or procedure, you must use that cate... Read more
Use 4 Steps for Reporting PA Assisits at Surgery
Avoid modifier AS in teaching hospitalsIf your surgeon uses a physician assistant (PA) to ... Read more
Physician Assistants 101:
What You Need to Know
PAs are licensed healthcare professionals who may, under a physician's supervision, practi... Read more
Get Pain Pump Claims On-Track With Continuous Infusion Codes
Payers may refuse coverage, so ask the patient to sign an ABNIf you're looking for the cod... Read more
The Basics:
Continuous Infusion Pain Pumps
Continuous infusion pain pumps as described by 64416, 64446, 64448 and 64449 provide a con... Read more
READER QUESTIONS:
22630 Forms the Basis of PLIF
Question: Which code (or codes) should I use to report PLIF without posterolateral fusion ... Read more
READER QUESTIONS:
Report Arthrodesis per Interspace, Not per Level
Question: The surgeon performed anterior fusion from L1 to L3. We reported one unit of 225... Read more
READER QUESTIONS:
Reduced Craniectomy Warrants 52
Question: Our surgeon removed a basal cell carcinoma that extended below the skin to the s... Read more
READER QUESTIONS:
Corpectomy Includes Diskectomy
Question: When reporting corpectomy, can I bill separately for the decompression/diskectom... Read more
READER QUESTIONS:
Racz Procedures=Lysis of Spinal Adhesions
Question: What is the appropriate code to describe a Racz procedure?Missouri Subscriber A... Read more
READER QUESTIONS:
22851 Is the Way for PEEK
Question: What is "PEEK" and how can I code for it?New Jersey Subscriber Answer: "PEEK" i... Read more
You Be the Coder:
What Service Does 61795 Describe?
Question: Is 61795 for intraoperative navigation, or for planning prior to surgery?Kansas ... Read more
Adapt a 2-Part Strategy for Subcutaneous Cranial Bone Grafts
Complete reporting requires at least 4 codes over 2 operative sessions When your surgeon ... Read more
Time Really Does Equal Money For E/M Coding
Counseling can increase your service level, regardless of other E/M criteria If you're fo... Read more
Excision, Placing Chemo Agent Call for Separate Codes
Avoid confusing brachytherapy with carmustine disks If your surgeon places intracavitary ... Read more
Coding Briefs:
CMS Revises Fee Schedule, New ICD-9 Code for CNS Infections
If you're trying to stay up to date with all the latest coding information, you don't want... Read more
Reader Questions:
Time Matters for Complex Neurostimulators
Question: Should I consider time when choosing a neurostimulator programming code?New York... Read more
Reader Questions:
Post-Fusion Injections May Require Unlisted Code
Question: Which codes should I report if the physician documents "hardware injections in t... Read more
Reader Questions:
Size Isn't All That Matters for Complexity
Question: What differentiates a "simple" aneurysm from a "complex" aneurysm? Does a diffic... Read more
Reader Questions:
Fluoroscopy Matches With Diskography Injection
Question: Can I report 76005-26 with 62290?South Carolina Subscriber Answer: You'll almos... Read more
Reader Questions:
Master Diagnoses for Facet Joint Injections
Question: Will I have trouble receiving reimbursement for facet joint injections (64470-64... Read more
Reader Questions:
How to Choose Between Hospital Follow-up Codes
Question: When the surgeon performs an inpatient consult, I bill 99251-99255. Should I cod... Read more
Reader Questions:
Include Spondylolisthesis Reduction in Definitive Procedure
Question: Which CPT code should we report when the surgeon performs a reduction of spondyl... Read more
You Be the Coder:
795 Appropriate With Spine Surgery?
Question: Our surgeon used stereotactic navigation (+61795) during laminectomy with fusion... Read more
Learn the Neuroendoscopy 3-Step for Easy Code Application
Choose either the open or the endoscopic code - never bothTo report neuroendoscopic proced... Read more
Look for Better Kyphoplasty, Vertebroplasty Coverage
Continue to use 22899 for Medicare kyphoplasty claimsPractices billing for percutaneous ky... Read more
Know Your Neuroendoscopy Codes
CPT added six codes to describe neuroendoscopy in 2003: + 62160 - Neuroendoscopy, intracr... Read more
NCCI Update:
Watch for New Excision, Arthrodesis Bundles
Modifier -59 can still provide for separate billing, when necessaryIf you're billing arthr... Read more
Don't Miss Out on 69990 Reimbursement Opportunities
Take the step of checking NCCI before reporting operating microscope If you're ov... Read more
Coding Brief:
Medicare Follows Private-Payer Lead on PET Scan Coding
You can finally ditch the HCPCS G codes when reporting positron emission tomography (PET) ... Read more
READER QUESTIONS:
Read Entire Op Note Before Coding Vertebroplasty
Question: The surgeon performed a complete T7 and partial T6 corpectomy with vertebroplast... Read more
READER QUESTIONS:
Look to CPT for Facet Joint Instructions
Question: Is it appropriate to use modifier -50 for bilateral facet joint injections (6447... Read more
READER QUESTIONS:
Choose POS 21 for Inpatient
Question: We rushed a patient into surgery from the emergency department. The physician di... Read more
READER QUESTIONS:
Written Consult Request Isn't Mandatory
Question: We've heard conflicting information about the requirement for a written request ... Read more
READER QUESTIONS:
Observation Status Is Outpatient
Question: When providing a consult for a patient admitted to observation, should we report... Read more
READER QUESTIONS:
Report 1 Unit for Neurostim Laminectomy
Question: Recently, I reported 63655 x 3 (levels T10-T11-T12) for laminectomies to place n... Read more
You Be the Coder:
How Should You Report Bone Healing Stimulator?
Question: Our physician inserted a bone healing stimulator. How should we report this serv... Read more
Want the Facts on Facet Joint Injections? Look No Further
Count levels treated, not injections, for 64470-64476 When claiming facet joint injection... Read more
Don't Forget Fluoroscopic Guidance With Nerve Blocks
If your surgeon provides fluoroscopic guidance that allows her to place the needle for fac... Read more
Bill for Wasted Supplies to Save Your Bottom Line
Schedule multiple Botox treatments in same 4-hour block Under Medicare rules, you can rec... Read more
News in Brief:
AMA May Develop Its Own Correct Coding Initiative
Neurosurgery coders may soon face an additional layer of guidelines, because the American ... Read more
4 Steps Will Ease Your 'Unusual Procedure' Claims
When it comes to modifier -22, you have to ask to receive Appending modifier -22 won't au... Read more
Medicare Proposes, Rescinds 'Medically Unbelievable' Edits
Regulations would have enacted per-day limits on certain codes If you've heard rumors of ... Read more
Reader Questions:
Unlisted-Procedure Code Best for Artificial Disk
Question: Which code should I use to describe placement of artificial disks? I'm leaning t... Read more
Reader Questions:
Destruction Codes Describe RFTC
Question: How can I report the use of radiofrequency thermal coagulation (RFTC) to disable... Read more
Reader Questions:
Global Determines Postprocedure Coding
Question: Following low-back surgery, we had to readmit the patient for a wound abscess. C... Read more
Reader Questions:
Previous Hospital Care May Affect E/M
Question: A provider insurance representative recommended at an in-house seminar that if o... Read more
Reader Questions:
Payers Treat Group Practices as 1 Provider
Question: If surgeon 2, in our group practice, provides post-op care for a patient whom su... Read more
Reader Questions:
Limit -77 to Same Day
Question: One of our surgeons performed a decompressive laminectomy for a patient in 2001.... Read more
Reader Questions:
Edits Shouldn't Deny Fusion Removal/Reconstruction Payment
Question: Our surgeon removed anterior instrumentation and reconstructed the lumbar spine ... Read more
You Be the Coder:
Can You Report Multiple Spinal Excisions?
Question: The surgeon performed complete laminectomy with decompression and excision of ep... Read more
Get the Most Out of PLIF
Don't overlook the chance to report bone grafts Before you report posterior lumbar interb... Read more
Access Reoperative Codes for Postlaminectomy Syndrome
Turn to modifier -50 for bilateral procedures When your neurosurgeon performs surgical tr... Read more
3 Pointers Help Optimize Your Radiosurgery Claims
You can report 61793 more than once for multiple lesions  If you're reporting stereo... Read more
Bundling's the Thing for Mental Status Exams
Counseling could lead to time-based E/M coding When you code a mini-mental status exam (M... Read more
Look to the Original Procedure For Modifiers -78 and -79
To decide between modifiers -78 and -79 for a procedure during the postoperative period of... Read more
Reader Questions:
Don't Bill Separately for 'Minimal' Diskectomy
Question: The surgeon's documentation specified anterior arthrodesis with diskectomy. I re... Read more
Reader Questions:
Same Stay = Follow-up Consult
Question: Our surgeon was called for an inpatient consult with an auto-vehicle-accident pa... Read more
Reader Questions:
3 Vertebrae Doesn't Mean 3 Fusions
Question: If the surgeon fuses vertebrae L1 through L3, should I report 22612, 22614, or 2... Read more
Reader Questions:
Payer Matters for Dead-Patient Discharge
Question: Can our surgeon file a claim for pronouncing a patient dead? This sometimes requ... Read more
Reader Questions:
64721 Covers CTS Surgery
Question: Which code describes surgical treatment of CTS?Oklahoma Subscriber Answer: ... Read more
Reader Questions:
Destruction Codes Describe RFTC
Question: How can I report the use of radiofrequency thermal coagulation (RFTC) to disable... Read more
You Be the Coder:
What's the Limit for 22851?
Question: How should I code if the surgeon places multiple instrumentation cages? What abo... Read more
Answer 3 Questions to Choose the Correct Skull Surgery Approach Code
Surgeon/coder communication and flawless documentation are a must for 61580-61598To find t... Read more
Modifier -25 Isn't Always the Answer for a Same-Day E/M
Turn to -57 for evaluations with major surgical proceduresIf the neurosurgeon provides an ... Read more
CPT Update:
AMA Leaves Open Questions For Open-Door Laminoplasty
63051 will be useful, but experts can't agree on 63050You can safely report 63051 for trad... Read more
Correction:
Report Arthrodesis per Interspace
In the January 2005 Neurosurgery Coding Alert, Vol. 6, No. 1, the example described in "Sc... Read more
READER QUESTIONS:
Look to -32 for Confirmatory Consult
Question: Recently, a private (non-Medicare) insurer requested that our neurosurgeon provi... Read more
READER QUESTIONS:
Check Date When Coding Admission From ED
Question: When our neurosurgeon admits a patient to the hospital after hours from the emer... Read more
READER QUESTIONS:
Separate Hematoma Evacuation Requires -59
Question: Our surgeon performed excision of a brain tumor followed by hematoma evacuation ... Read more
READER QUESTIONS:
Don't Count Out Conscious Sedation for 2005
Question: I've heard rumors that CPT will begin bundling conscious sedation to spinal taps... Read more
You Be the Coder:
Is Microdiskectomy Separate?
Question: The surgeon performs lumbar decom-pression bilaterally at segments L4 and L5. At... Read more
Laminectomy or Hemilaminectomy? Let Documentation Be Your Guide
Make sure you're not confusing spinal segments with interspaces To code correctly for lami... Read more
'Extended' Laminectomy Calls for Special Coding
You can report laminectomy and laminotomy together, if required If the surgeon extends a ... Read more
Here's Your Rx for Inpatient E/M Headaches
4 rules help you select between initial and subsequent visits You can take control of you... Read more
2005 Fee Schedule Update:
Count on Decent Laminoplasty, Reduced Vertebroplasty Fees
Along with a 1.5 percent across-the-board payment increase, the 2005 Physician fee schedul... Read more
Reader Questions:
Time, Documentation Critical to 99291 Payment
Question: In the afternoon, our surgeon saw an auto accident victim with internal head inj... Read more
Reader Questions:
Fight for 61795 Payment if Necessary
Question: I receive constant denials from Medicare for 61795. When I ask which codes are a... Read more
Reader Questions:
Medicare Won't Recognize 'After-Hours' Codes
Question: Will Medicare pay extra for the surgeon seeing the patient for an unscheduled ap... Read more
Reader Questions:
Turn to Twist Drill/Burr Hole for Monitor Placement
Question: What is the correct code for placement of right frontal Camino intracranial pres... Read more
You Be the Coder:
Which Code Works for Gliadel Wafers?
Question: How can I code for placement of Gliadel Wafers? Is there a dedicated code for th... Read more
What if That 'Simple' Intracranial Aneurysm Isn't So Simple? Here's What to Do
Upcoding isn't the answer, experts say The AMA provides exacting criteria to define a com... Read more
'Complex' Differs for AV Malformations
You shouldn't apply the same "simple versus complex" rules for intracranial arteriovenous ... Read more
Same-Day Modifiers, Part 1:
Modifiers -25, -51 and -59 SaveSame-Day Services
Append the correct modifier to achieve fair multiple-procedure payment  If your neur... Read more
Quick Quiz:
4 Scenarios Measure Your -25,-51, -59 Knowledge
Take this opportunity to test your abilities by choosing the correct modifier (-25, -51 or... Read more
2005 Physician Payments Rise
Expect a 1.5 percent overall increase CMS has unveiled its "Revisions to Payment Policies... Read more
READER QUESTIONS:
Report a Single Fluoroscopy Code
Question: During a major spine surgery, the neurosurgeon used fluoroscopy for four hours. ... Read more
READER QUESTIONS:
Fee Schedule Reveals Assistant Surgeon Eligibility
Question: Can we bill for an assistant surgeon when reporting 61751?Vermont Subscriber An... Read more
READER QUESTIONS:
Choose 99235 for Physician Who Examines Patient
Question: Dr. Smith was on-call and admitted a patient to the hospital. On the same day, o... Read more
READER QUESTIONS:
Skip -50 for Bilateral Craniotomy
Question: How should I report bilateral frontal craniotomy for evacuation of subdural hema... Read more
READER QUESTIONS:
Global Periods Can Vary for Unlisted-Procedure Codes
Question: Does Medicare assign a global period for unlisted-procedure codes? For instance,... Read more
You Be the Coder:
'Inter-region' Location a Matter of Interpretation
Question: Would the C7/T1 interspace be considered cervical or thoracic?Michigan Subscribe... Read more
Available Years:  2005  2004  2003  2002  2001  2000