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Neurosurgery Coding Alert

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... Read more
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... Read more
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... Read more
Reader Question:
Use Specific Codes for Burst Fractures
Question: How do we report T11 and T12 laminectomies done to decompress the spinal cord fr... Read more
Reader Question:
Do Not Forget the Assistant Services
Question: Our surgeon placed an epidural drug infusion pump. An assistant helped in this p... Read more
Reader Question:
Look for Procedures Inclusive in Corpectomy
Question: Through anterior approach to the lumbar spine at L3 toS1, our surgeon did diskec... Read more
Reader Question:
Code for Tumor in Skull Osteoma
Question: How do we code for a resection of a skull osteoma?Georgia SubscriberAnswer: You ... Read more
Reader Question:
Do Not Duplicate Botox Injections
Question: On the same day, our surgeon injected Botox into the forehead for migraine heada... Read more
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... Read more
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... Read more
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... Read more
Case Study:
Capture PEEK Cage Reimbursement By Counting Levels
Your surgeon may use polyetheretherketone (PEEK) cages to achieve cervical interbody fusio... Read more
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... Read more
Reader Question:
Never Report 63267 and 63017 Together
Question: Can we bill together 63267 (Laminectomy for excision or evacuation of intraspina... Read more
Reader Question:
Look Who Does the Intraoperative Monitoring
Question: Can we bill intraoperative monitoring if it is read by a different physician tha... Read more
Reader Question:
Watch Timing for Cervical Traction
Question: Our surgeon did suboccipital craniectomy with C1 and C2 laminectomies, occipital... Read more
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... Read more
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... Read more
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... Read more
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... Read more
Reader Question:
Know When to Report the Dural Repairs
Question: The surgeon performed a right L4-L5 lumbar microdiskectomy using the microscope ... Read more
Reader Question:
Code the Post-Craniotomy Infection
Question: A patient who had a craniotomy 8 years ago presented with an infection of the wo... Read more
Reader Question:
Look At Technique for Diskectomy and Fusion
Question: Is it right to report 22899 (Unlisted procedure, spine) or 64999 (Unlisted proce... Read more
Reader Question:
Do Not Miss the Bone Grafts in Cranioplasty
Question: How should we report the artificial bone graft for cranioplasty?Ohio SubscriberA... Read more
Reader Question:
Check Revised Policy for Billing 61781 With 61510
Question: Can we bill 61781 with 61510?Alaska SubscriberAnswer: Medicare recently revised ... Read more
You Be the Coder:
Report the Intraoperative Neuromonitoring
Question: Our neurosurgeon performed the following procedures:1) Direct lateral L4-L5 disk... Read more
Coding Strategy:
6 Tips Keep Your Spinal Punctures Payment Flowing
Key: Intent and modifiers will salvage you.Ostensibly simple, the codes for spinal punctur... Read more
Report Other E/M Procedures
Your surgeon may decide to do a diagnostic or therapeutic puncture as an office procedure ... Read more
Coding Tips:
Learn 3 Codes Spinal Dura Repairs
Concurrent laminectomies are your guide.When repairing a dural tear, your surgeon may or m... Read more
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... Read more
Reader Question:
Report Work of Each Surgeon
Question How do we report when two surgeons in the same practice worked for the surgery? T... Read more
Reader Question:
Report Multiple Laminectomies
Question Our doctor performed a T10, T11-12, L1, L2, and L3 laminectomy and foraminotomy w... Read more
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... Read more
Reader Question:
Code the Segmental Instability
Question: Is there a separate ICD-9 code for relative segmental instability? The surgeon d... Read more
Reader Question:
When to Look For Global Period
Question: If a code has global period designation in the fee schedule which implies that i... Read more
You Be the Coder:
Learn More for Hemicorpectomy
Question: Patient underwent anterior cervical discectomy and fusion (ACDF) at C5-6 and C6-... Read more
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... Read more
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... Read more
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... Read more
Exercise Caution on Sedation
The procedures for trigeminal neuralgia are performed under sedation, usually by an anesth... Read more
Reader Question:
Strengthen Your Stereotactic Coding
Question: What code can I report when my doctor did stereotactic radiosurgery for an acous... Read more
Reader Question:
Append Correct Modifier for Cyberknife
Question: Our surgeon performed cyberknife on three different days for multiple intracrani... Read more
Reader Question:
Correctly Report Quadriplegia
Question: What is the diagnosis code for acute onset quadriplegia with C4-C6 fractures?Mar... Read more
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... Read more
Coding Strategies:
Advice Helps You Master Facet Joint Injection Essentials
Count each level and check for your payers' preferencesWhen reporting facet joint injectio... Read more
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... Read more
Modifier Justified:
Report Co-surgeries to Capture Deserved Payment
Procedure, modifier and documents determine your paymentIt's common in neurosurgery to enc... Read more
Reader Question:
Discern When to Report Discographies
Question: Can 62290 and 62287 be reported for the same level?Alaska SubscriberAnswer: Code... Read more
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... Read more
Reader Question:
Read the Approach for Corpectomy
Question: Is it appropriate to report 64999 when the surgeon does T1 and T2 corpectomies t... Read more
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 ... Read more
Reader Question:
Never Miss the Hardware in Fluoroscopy
Question: How does one report for the injections around the hardware with fluoroscopy? Our... Read more
You Be the Coder:
Code the Interspinous Spacers
Question: How does one report the placement of interspinous spacer during a posterior arth... Read more
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... Read more
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... Read more
Never overlook evaluation and management services
Be vigilant for series of events in the postoperative periodYou will need to read the oper... Read more
Modifier Mythbuster:
Debunk These Top Modifier 22 Myths
Right use of modifier 22 can yield the right paymentsLast issue we learned that modifier 2... Read more
Reader Question:
Understand the Pericranial Flaps
Question: Do we separately report the harvesting of pericranial flaps in cranial procedure... Read more
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... Read more
Reader Question:
Code Post-Traumatic Hematomas with Confidence
Question: How do we code for supratentorial craniotomy with evacuation of subdural hematom... Read more
Reader Question:
Learn To Code for X-Close
Question: Does one code for X-Close when doing a discectomy?Mexico SubscriberAnswer: The X... Read more
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... Read more
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 ... Read more
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... Read more
Modifier Mythbuster:
Debunk These Top Modifier 22 Myths
Appending modifier 22 for increased procedural services may increase the chances of an aud... Read more
Reader Questions:
Discretely Report Arthrodesis Codes
QuestionCan we bill 22630 and 22612 together? Alabama SubscriberAnswerCodes 22630 (Arthrod... Read more
Reader Questions:
Correctly Code for Spinal Metastatic Tumors
QuestionIf the surgeon performs an 11-level thoracic laminectomy for bilateral removal of ... Read more
Reader Questions:
Look for the Reason in Craniectomies
QuestionIs the code 61322 solely for raised intracranial pressure (may be due to trauma) o... Read more
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... Read more
Reader Questions:
Can 61510 and 61781 Be Billed Together
QuestionWhen coding 61510 and 61781, Medicare denied payment for 61781, stating 'Claim /se... Read more
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... Read more
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... Read more
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... Read more
Coding Update:
Crack the Codes for Ventricular Shunts
Replacement, reprogramming, or removal could help recover earned reimbursementVentricular ... Read more
Billing Strategies:
Heed 3 Caveats When Writing Off Patient Balances
Case study helps you steer clear of audit pitfalls.Being a compassionate, caring practice ... Read more
Reader Questions:
Code For Cranial Expansion In A Long-Standing Hydrocephalus
Question: The neurosurgeon performed a cranial expansion in a longstanding hydrocephalus t... Read more
Reader Questions:
Select Site for Metastasis in Spine
Question: If the procedure planned is T7-T9 laminectomy for a metastatic carcinoma, is the... Read more
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... Read more
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... Read more
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... Read more
ICD-9/ICD-10 Cross Reference
Bone Up on Dx Changes for Intracerebral HemorrhageICD-10 implementation is coming in 2013 ... Read more
Spinal Decompression Update:
Finesse Your MILD Coding With These Refinements
See how turning to 63030, 63047 could trip you up.Accurately reporting minimally invasive ... Read more
Coding Tips:
4 Questions Help Pin Down Headache Dx Choice
Occipital nerve block coding tips help you nail these claims.If your neurosurgery practice... Read more
Reader Questions:
Identify Right Transcervical Approach For Tumor Resection
Question: My neurosurgeon performed a right transcervical approach for a resection of a T1... Read more
Reader Questions:
Include Boneflap Work for Brain Biopsy
Question: The physician performed a left temporoparietal craniotomy with an open brain tum... Read more
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... Read more
Reader Questions:
Scrutinize Global Period for Recurrent Herniation
Question: Our patient had a LT lumbar discectomy in November 2010. He has had recurrent he... Read more
Reader Questions:
Determine Approach for Rhizotomy
Question: How should I report an occipital rhizotomy?Washington SubscriberAnswer: Although... Read more
Reader Questions:
Look to 22849 For Instrumentation Reinsertion
Question: When the surgeon removes instrumentation and reinserts the instrumentation at th... Read more
Reader Questions:
Separate Anterior and Posterior Approaches for Cervical Fusion
Question: Our neurosurgeon performed a 3-level anterior cervical fusion w/corpectomy, disc... Read more
Reader Questions:
Review Craniectomy for Malignant Edema Steps
Question: I would appreciate help coding the following procedure: Procedure:1. Right-sided... Read more
You Be the Coder:
Decortication for Dural Tear
Question: Would 63709 be appropriate for the decortication procedure below? Pre-op/Post-op... Read more
Coding Strategies:
3 Tips Boost Your PLIF Claims Success
Key: Don't overlook the chance to report bone grafts.When your neurosurgeon performs poste... Read more
CCI 17.1:
Nix Fluoroscopic Guidance for These Trigger Points
New chemodenervation code includes injections.CCI 17.0 establishes non-mutually exclusive ... Read more
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... Read more
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... Read more
Reader Questions:
63276 Gets Separate Treatment With Corpectomy Service
Question: My physician did a T5 and T6 corpectomy (63101, Vertebral corpectomy (vertebral ... Read more
Reader Questions:
Bilateral Hematoma Evacuation Merits Appeal
Question: My surgeon reported 61312 (Craniectomy or craniotomy for evacuation of hematoma,... Read more
Reader Questions:
Try This For Tri-level Laminectomy With Biopsy
Question: My doctor is performing a 63278 (Laminectomy for biopsy/excision of intraspinal ... Read more
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... Read more
Reader Questions:
Base Parietooccipital Craniotomy Code Choice on Tumor Location
Question: Can you help me with this operative report for a parietooccipital craniotomy? I ... Read more
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... Read more
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