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Neurosurgery Coding Alert
Neurosurgery Coding Alert
Neurosurgery Coding Alert - 2011, Volume 12, Number 12
2012 Update:
Equip Yourself With New Codes To Report Neurolysis in 2012
Keep a count of joints, regardless of the numbers of nerves. When reporting the paraverteb...
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Coding Strategies:
Heed These Spinal Instrumentation Coding Steps To Recoup All Deserved Pay
Approach, span and devices influence your claimWhen your neurosurgeon provides spinal inst...
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ICD-10 Update:
Let Specific Regions Guide Your Radiculopathy Dx
Single ICD-9 code expands to four codes in ICD-10.Radiculopathy gets site-specific for spi...
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Reader Question:
Use Specific Codes for Burst Fractures
Question: How do we report T11 and T12 laminectomies done to decompress the spinal cord fr...
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Reader Question:
Do Not Forget the Assistant Services
Question: Our surgeon placed an epidural drug infusion pump. An assistant helped in this p...
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Reader Question:
Look for Procedures Inclusive in Corpectomy
Question: Through anterior approach to the lumbar spine at L3 toS1, our surgeon did diskec...
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Reader Question:
Code for Tumor in Skull Osteoma
Question: How do we code for a resection of a skull osteoma?Georgia SubscriberAnswer: You ...
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Reader Question:
Do Not Duplicate Botox Injections
Question: On the same day, our surgeon injected Botox into the forehead for migraine heada...
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You Be the Coder:
Use Discrete Codes for Decompression and Arthrodesis in Cervical Region
Question: In a patient diagnosed with 'platybasia with occipitocervical instablity', our s...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 11
Neuroendoscopy Coding:
Three Easy Steps Strengthen Your Neuroendoscopy Reporting Accuracy
Top tip: Never use these codes for open surgery and endoscopy together. When your neurosur...
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Spinal Adhesions:
Adopt 4 Tips To Ace Lysis Of Spinal Adhesions Coding
Keep a count on days, not adhesions or injections. Revisions to CPT® in recent years...
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Case Study:
Capture PEEK Cage Reimbursement By Counting Levels
Your surgeon may use polyetheretherketone (PEEK) cages to achieve cervical interbody fusio...
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Reader Question:
Look At What the Surgeon Did To Decompress the Brachial Plexus
Question: If our surgeon does an exploration and decompression of the right brachial plexu...
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Reader Question:
Never Report 63267 and 63017 Together
Question: Can we bill together 63267 (Laminectomy for excision or evacuation of intraspina...
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Reader Question:
Look Who Does the Intraoperative Monitoring
Question: Can we bill intraoperative monitoring if it is read by a different physician tha...
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Reader Question:
Watch Timing for Cervical Traction
Question: Our surgeon did suboccipital craniectomy with C1 and C2 laminectomies, occipital...
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You Be the Coder:
Look For Levels of Reinsertion of Spinal Devices
Question: Our surgeon performed the following procedures:1) Hardware removal with fusion e...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 10
Coding Tips:
Zero In On Graft Source and Extra Services To Master Spinal Bone Grafts
Report multiple grafts but modifier -51 does not apply. Coding for spinal bone grafting ma...
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Coding Strategies:
Perfect Your Vertebral Fracture Repair Coding With This Advice
Balloon and cement? Identify technique, levels and regions to recoup full payment.When you...
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CCI 17.3 Update:
Look At Approach To Select A Code For Spinal Electrode Replacement
You select amongst percutaneously placed versus laminectomy placed electrodes.When reporti...
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Reader Question:
Know When to Report the Dural Repairs
Question: The surgeon performed a right L4-L5 lumbar microdiskectomy using the microscope ...
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Reader Question:
Code the Post-Craniotomy Infection
Question: A patient who had a craniotomy 8 years ago presented with an infection of the wo...
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Reader Question:
Look At Technique for Diskectomy and Fusion
Question: Is it right to report 22899 (Unlisted procedure, spine) or 64999 (Unlisted proce...
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Reader Question:
Do Not Miss the Bone Grafts in Cranioplasty
Question: How should we report the artificial bone graft for cranioplasty?Ohio SubscriberA...
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Reader Question:
Check Revised Policy for Billing 61781 With 61510
Question: Can we bill 61781 with 61510?Alaska SubscriberAnswer: Medicare recently revised ...
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You Be the Coder:
Report the Intraoperative Neuromonitoring
Question: Our neurosurgeon performed the following procedures:1) Direct lateral L4-L5 disk...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 9
Coding Strategy:
6 Tips Keep Your Spinal Punctures Payment Flowing
Key: Intent and modifiers will salvage you.Ostensibly simple, the codes for spinal punctur...
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Report Other E/M Procedures
Your surgeon may decide to do a diagnostic or therapeutic puncture as an office procedure ...
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Coding Tips:
Learn 3 Codes Spinal Dura Repairs
Concurrent laminectomies are your guide.When repairing a dural tear, your surgeon may or m...
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ICD-10 Made Easy:
Take the Pain Out of Pain Dx: Get Confident on G89
Look for site specific codes and include psychological factors.G89 (Pain, not elsewhere cl...
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Reader Question:
Report Work of Each Surgeon
Question How do we report when two surgeons in the same practice worked for the surgery? T...
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Reader Question:
Report Multiple Laminectomies
Question Our doctor performed a T10, T11-12, L1, L2, and L3 laminectomy and foraminotomy w...
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Reader Question:
Look For How the Brain Biopsy Was Done
Question: How does one report craniotomy for biopsy of brain lesion when the subsequent pa...
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Reader Question:
Code the Segmental Instability
Question: Is there a separate ICD-9 code for relative segmental instability? The surgeon d...
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Reader Question:
When to Look For Global Period
Question: If a code has global period designation in the fee schedule which implies that i...
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You Be the Coder:
Learn More for Hemicorpectomy
Question: Patient underwent anterior cervical discectomy and fusion (ACDF) at C5-6 and C6-...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 8
Coding Tips:
Use 3 Tips To Strengthen Your Skull Base Approach Coding
Fossa, dura, and approach will steer you to the right code.Accessing lesions in the intrac...
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ICD-10 Update:
ICD-10: Lower Back Pain Dx Gets More Specific in 2013
Make sure you know the laterality with ICD-10.Non-remitting backache is a common complaint...
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Coding Made Easy:
Nail The Correct Codes Every Time For Trigeminal Neuralgia
Tip: Location where the surgeon works is your dependable option.Coding for trigeminal neur...
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Exercise Caution on Sedation
The procedures for trigeminal neuralgia are performed under sedation, usually by an anesth...
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Reader Question:
Strengthen Your Stereotactic Coding
Question: What code can I report when my doctor did stereotactic radiosurgery for an acous...
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Reader Question:
Append Correct Modifier for Cyberknife
Question: Our surgeon performed cyberknife on three different days for multiple intracrani...
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Reader Question:
Correctly Report Quadriplegia
Question: What is the diagnosis code for acute onset quadriplegia with C4-C6 fractures?Mar...
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You Be the Coder:
Be Confident For Skull Base Approach
Question: A 50-year-old woman presented with visual field loss and diplopia secondary to a...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 7
Coding Strategies:
Advice Helps You Master Facet Joint Injection Essentials
Count each level and check for your payers' preferencesWhen reporting facet joint injectio...
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Coding Made Easy:
Simplify Your Complex Intracranial Aneurysm Reporting With These Tips
Location and character of an aneurysm are your best guidesIf aneurysm op notes cause you h...
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Modifier Justified:
Report Co-surgeries to Capture Deserved Payment
Procedure, modifier and documents determine your paymentIt's common in neurosurgery to enc...
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Reader Question:
Discern When to Report Discographies
Question: Can 62290 and 62287 be reported for the same level?Alaska SubscriberAnswer: Code...
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Reader Question:
Keep a Count on Cranial Nerves
Question: During an E/M when the neurosurgeon used the 97 exam, is it fine to just say cra...
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Reader Question:
Read the Approach for Corpectomy
Question: Is it appropriate to report 64999 when the surgeon does T1 and T2 corpectomies t...
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Reader Question:
Learn What to Report in Spinal Fusion
Question: When bone chips are used to fill the intervertebral space, do we need to report ...
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Reader Question:
Never Miss the Hardware in Fluoroscopy
Question: How does one report for the injections around the hardware with fluoroscopy? Our...
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You Be the Coder:
Code the Interspinous Spacers
Question: How does one report the placement of interspinous spacer during a posterior arth...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 6
Coding Strategies:
Follow These Steps To Ensure Correct And Complete Spinal Neurostimulator Reporting
Attention to trials and reprogramming can help to strengthen your claimsYour chances of su...
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ICD-9/ICD-10 Crosswalk
...
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Global Reporting Tips:
Strengthen Your Global Fee Claims With These Tips
Your surgeon may end up offering free care in the global period if you miss reporting a se...
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Never overlook evaluation and management services
Be vigilant for series of events in the postoperative periodYou will need to read the oper...
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Modifier Mythbuster:
Debunk These Top Modifier 22 Myths
Right use of modifier 22 can yield the right paymentsLast issue we learned that modifier 2...
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Reader Question:
Understand the Pericranial Flaps
Question: Do we separately report the harvesting of pericranial flaps in cranial procedure...
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Reader Question:
Code Correct For Neurectomy of the Sural Nerve
Question: How does one code for neurectomy of the sural nerve at the level of the ankle?Oh...
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Reader Question:
Code Post-Traumatic Hematomas with Confidence
Question: How do we code for supratentorial craniotomy with evacuation of subdural hematom...
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Reader Question:
Learn To Code for X-Close
Question: Does one code for X-Close when doing a discectomy?Mexico SubscriberAnswer: The X...
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You Be the Coder:
Differentiate Laminectomy and Discectomy
Question: Patient has herniated disc at the L4-5 and L5-S1 as well as neural foraminal ste...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 5
Coding Update:
Boost Your Burr Hole Coding Accuracy with This Advice
Take heed of bone flaps and be watchful for sites to avoid missing a correct codeYou ...
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ICD-9/ICD-10 Crosswalk
...
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Craniotomy Strategies:
Code for Location and Etiology in Craniotomies
Payment depends on what precedes and follows the procedure.You'll stand a much better chan...
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Modifier Mythbuster:
Debunk These Top Modifier 22 Myths
Appending modifier 22 for increased procedural services may increase the chances of an aud...
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Reader Questions:
Discretely Report Arthrodesis Codes
QuestionCan we bill 22630 and 22612 together? Alabama SubscriberAnswerCodes 22630 (Arthrod...
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Reader Questions:
Correctly Code for Spinal Metastatic Tumors
QuestionIf the surgeon performs an 11-level thoracic laminectomy for bilateral removal of ...
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Reader Questions:
Look for the Reason in Craniectomies
QuestionIs the code 61322 solely for raised intracranial pressure (may be due to trauma) o...
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Reader Questions:
Report Distinct Services of Each Surgeon
QuestionIf both an ENT and neurosurgeon are using 61782 at the same time but each are usin...
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Reader Questions:
Can 61510 and 61781 Be Billed Together
QuestionWhen coding 61510 and 61781, Medicare denied payment for 61781, stating 'Claim /se...
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You Be the Coder:
Report Correct Codes for Vagal Nerve Stimulators
Question:Of the codes 64568 or 64568 and 61885-51, 95974, which one is appropriate to repo...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 4
Coding Strategies:
Simplify Your Spinal Osteotomies With These Tips
3 key factors you'll need to identify to avoid denials.When your neurosurgeon performs spi...
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ICD-9/ICD-10 Crosswalk:
Specify Kyphosis Type to Support Osteotomy Claims
To appropriately support your spinal osteotomies reporting, you'll need to indicate underl...
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Coding Update:
Crack the Codes for Ventricular Shunts
Replacement, reprogramming, or removal could help recover earned reimbursementVentricular ...
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Billing Strategies:
Heed 3 Caveats When Writing Off Patient Balances
Case study helps you steer clear of audit pitfalls.Being a compassionate, caring practice ...
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Reader Questions:
Code For Cranial Expansion In A Long-Standing Hydrocephalus
Question: The neurosurgeon performed a cranial expansion in a longstanding hydrocephalus t...
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Reader Questions:
Select Site for Metastasis in Spine
Question: If the procedure planned is T7-T9 laminectomy for a metastatic carcinoma, is the...
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Reader Questions:
Be Specific in PLIF and Interbody Fusion
Question: How do we code arthrodesis for deformity and PLIF, L2- S1 fusion with L4-S1 inte...
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You Be the Coder:
Rightly Code Lanx's Aspen Spinous Process Fixation System
Question: Can the placement of the Lanx's Aspen Spinous Process Fixation System be conside...
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Neurosurgery Coding Alert - 2011; Volume 12, Number 3
Coding Strategies:
Upgrade Your Subcutaneous Cranial Bone Graft Coding With This 2-Step Process
Tip: Don't forget retrieval services in your reporting.When your surgeon documents that he...
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ICD-9/ICD-10 Cross Reference
Bone Up on Dx Changes for Intracerebral HemorrhageICD-10 implementation is coming in 2013 ...
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Spinal Decompression Update:
Finesse Your MILD Coding With These Refinements
See how turning to 63030, 63047 could trip you up.Accurately reporting minimally invasive ...
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Coding Tips:
4 Questions Help Pin Down Headache Dx Choice
Occipital nerve block coding tips help you nail these claims.If your neurosurgery practice...
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Reader Questions:
Identify Right Transcervical Approach For Tumor Resection
Question: My neurosurgeon performed a right transcervical approach for a resection of a T1...
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Reader Questions:
Include Boneflap Work for Brain Biopsy
Question: The physician performed a left temporoparietal craniotomy with an open brain tum...
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Reader Questions:
Determine X-stop Extent for Code Choice
Question: What should I report for removal of an X-stop? Would 22850 (Removal of posterior...
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Reader Questions:
Scrutinize Global Period for Recurrent Herniation
Question: Our patient had a LT lumbar discectomy in November 2010. He has had recurrent he...
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Reader Questions:
Determine Approach for Rhizotomy
Question: How should I report an occipital rhizotomy?Washington SubscriberAnswer: Although...
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Reader Questions:
Look to 22849 For Instrumentation Reinsertion
Question: When the surgeon removes instrumentation and reinserts the instrumentation at th...
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Reader Questions:
Separate Anterior and Posterior Approaches for Cervical Fusion
Question: Our neurosurgeon performed a 3-level anterior cervical fusion w/corpectomy, disc...
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Reader Questions:
Review Craniectomy for Malignant Edema Steps
Question: I would appreciate help coding the following procedure: Procedure:1. Right-sided...
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You Be the Coder:
Decortication for Dural Tear
Question: Would 63709 be appropriate for the decortication procedure below? Pre-op/Post-op...
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Neurosurgery Coding Alert - 2011; Volume 12, Number A
Coding Strategies:
3 Tips Boost Your PLIF Claims Success
Key: Don't overlook the chance to report bone grafts.When your neurosurgeon performs poste...
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CCI 17.1:
Nix Fluoroscopic Guidance for These Trigger Points
New chemodenervation code includes injections.CCI 17.0 establishes non-mutually exclusive ...
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Evaluation and Management:
Untangle Review of Systems Knots To Accurately Choose Level 4 and 5 E/M Codes
Is each system documented? If not, prepare to assign a lower code.Level-four and level-fiv...
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Reader Questions:
Keep Laminectomy Focus in Syrinx-to-Subarachnoid Shunt Code Choice
Question: I was wondering if you could give me any advice on the correct coding for a syri...
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Reader Questions:
63276 Gets Separate Treatment With Corpectomy Service
Question: My physician did a T5 and T6 corpectomy (63101, Vertebral corpectomy (vertebral ...
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Reader Questions:
Bilateral Hematoma Evacuation Merits Appeal
Question: My surgeon reported 61312 (Craniectomy or craniotomy for evacuation of hematoma,...
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Reader Questions:
Try This For Tri-level Laminectomy With Biopsy
Question: My doctor is performing a 63278 (Laminectomy for biopsy/excision of intraspinal ...
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Reader Questions:
Choose Between 64421 and 64420 For Intercostal Nerve Block
Question: If the physician provides a single injection for a thoracic intercostal nerve bl...
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Reader Questions:
Base Parietooccipital Craniotomy Code Choice on Tumor Location
Question: Can you help me with this operative report for a parietooccipital craniotomy? I ...
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You Be the Coder:
Choose One of Two Methods for Multiple Aneurysms
Question: One of our patients has multiple complex cerebral aneurysms (5). Our neurosurgeo...
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