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Neurosurgery Coding Alert

Coding Strategy:
Follow This Step-Wise Approach To Report Cranial Bone Graft Procedures
4 keys to unlocking pay: The primary procedure, flap removal, retrieval, and replacement... Read more
Coding Tips:
4 Tips Strengthen Your Spinal Catheter Reporting
Hint: Code for tunneled vs non-tunneled approach; check for follow-up. Spinal catheters... Read more
Coding Strategy:
Swim Downstream To Full Gill Procedure Pay With These Tactics
Rule out fusion and confirm decompression. The Gill procedure, though not commonly done... Read more
Brush Up on Laminectomy Basics
The lamina is the posterior arch of the vertebral bone. The lamina lies between the spin... Read more
Reader Question:
Earn For Redo Spinal Procedures
Question: How do we report the following? Decompressive Laminectomies Total L3, parti... Read more
Reader Question:
Check Bundle In Device Removal and Laminectomy
Question: How do we report the procedures described in the operative note below: "The p... Read more
Reader Question:
Confirm Site of Graft Harvest
Question: How do we bill for right temporal craniotomy with reconstruction of skull base... Read more
Reader Question:
Report Spinal Bone Stimulator Removal as Unlisted
Question: What is the correct CPT® code for the removal of a spinal bone stimulator?... Read more
Reader Question:
Remove Your Doubts for Drain Removal
Question: Surgeon A performed a posterolateral fusion, laminectomy, and pedicle screw in... Read more
You Be the Coder:
Determine Nature and Location of Spinal Mass
Question: Our surgeon did a cervical laminotomy from C6-T1 with resection of a spinal ma... Read more
Coding Case:
Strengthen Your Spinal Reporting With This Stepwise Approach
Consider discectomy and facetectomy bundled in interbody fusion.Spinal coding may pose a c... Read more
ICD 10 Update:
ICD 10 Amplifies Nontraumatic Subarachnoid Hemorrhage Choices
Pay attention to site and side of the hemorrhage.You may find it confusing to move from on... Read more
Basics of Brain Circulation
The main arteries that supply the brain include the vertebral arteries, basilar artery, an... Read more
Gear Up To Meet The ICD-10 Deadline In 2014
The Oct. 1 2014 compliance date is now set for the International Classification of Disease... Read more
CCI Edit 18.3:
Use Modifiers For Wound Repair Codes When Reporting With Central Tap Or Puncture
Watch for bundling and guard your payment.The new CCI edit 18.3 bundles the wound repair c... Read more
Reader Question:
Count Levels for Laminectomy
Question: How do we report decompression laminectomy at L4-L5? Do we count this as two lev... Read more
Reader Question:
Know When to Report Diagnostic Angiogram with Intervention
Question: Can we bill diagnostic angiograms done during the same operative session as an a... Read more
Reader Question:
Do Not Report 63056 and 22630 for Same Segment
Question: Is it ok for us to report code 63056 (Transpedicular approach with decompression... Read more
Reader Question:
Check Components of Ventricular Catheters
Question: Can we bill codes 62225 (Replacement or irrigation, ventricular catheter) and 62... Read more
Reader Question:
You Have Limited Options For Spinal Subdural Hematoma
Question: What is the ICD 9 code for lumbar subdural hematoma?Missouri SubscriberAnswer: T... Read more
Reader Question:
Count Each Level In Spine Procedures
Question: In a patient diagnosed with cervical fracture C7-T1, our surgeon did a C7-T1 pos... Read more
You Be the Coder:
Do Not Mistake Osteoma for Osteomyelitis
Question: How do we report removal of exostosis (osteoma) of forehead under general in OR?... Read more
Coding Case Study:
Unlock Payment For Burr Hole Drainage Of Subdural Hemorrhage
Tip: Appropriate modifiers are the best rescue for your claims.You can confidently report ... Read more
ICD-10 Update:
Confirm Chronicity For Nontraumatic Subdural Hemorrhage
Make sure your surgeon documents acute, subacute, chronic.ICD-9 offers a single code for r... Read more
CPT® 2013:
Use These Codes To Strengthen Your Unlisted Procedure Reporting
Do not forget to confirm with your payer.Are you reporting a service that is rare, unusual... Read more
Modifier Tips:
Unravel the Mysteries of Modifier Use for Postop Procedures
Check global period for initial procedure and reason for second procedure.You may be leavi... Read more
Reader Question:
Do Not Report Burr Holes For Ventriculoperitoneal Pump
Question: One of our surgeons is looking at placing a "VENTRICULO-PERITONEAL" baclofen pum... Read more
Reader Question:
Earn For Every Level In Spinal Fusion
Question: Our surgeon does a T10-L2 posterior lumbar fusion in addition to open vertebropl... Read more
Reader Question:
Get Specific for Instrumentation and Grafts in Spinal Procedures
Question: Our surgeon did the following procedures using the posterior thoracolumbar ... Read more
You Be the Coder:
Get Definitive Diagnosis for Post-op Complaints
Question: We have case where the patient was admitted back to the hospital during the glob... Read more
Coding Case:
Patch Your Ventricular Puncture Payment Holes With These Pointers
Hint: Injections, if any, guide your choice of codes.When reporting your surgeon's ventric... Read more
Coding Tips:
4 Best Practices Ethically Maximize Your Microsurgery Reimbursement
Identify primary procedure and bundles -- and watch the units you report.Reporting yo... Read more
ICD-10 Update:
Pinpoint Site to Accurately Report Contusions Of Head In ICD-10
Don't assume just any closed injury is a contusion.If your surgeon notes a nonspecific dia... Read more
Reader Question:
Do Not Bill Multiple Units for Spinal Cage
Question: Below are details of a procedure our surgeon did.Procedure:T9 corpectomy.T7, T8,... Read more
Reader Question:
Circumvent Denials for 22845 with Discectomy
Question: Patient had anterior cervical discectomy and fusion (ACDF) at C4-6 and had previ... Read more
Reader Question:
Code Each Level of Cervical Spinal Procedures
Question: Our surgeon recorded the following procedures.Preoperative diagnoses:C2 arthriti... Read more
Reader Question:
Confirm Timing and Reason For Re-Do Craniotomy
Question: How can we report for re-do craniotomy? Our surgeon had to re-resect a tumor don... Read more
You Be the Coder:
Check If Your Surgeon Is Decompressing Nerves
Question: Would the appropriate code for a retrosigmoid suboccipital craniectomy for mass ... Read more
CCI Edits 18.2:
CCI Edits: Keep An Eye On 0239T Bundling
Do not bill for injections or infusions in spine with left atrial hemodynamic monitoring.T... Read more
Coding Case:
Heed These Pointers For Tallying Subdural Taps In Infants
Hint: Laterality does not matter but be sure to track the number of attempts. When your ne... Read more
ICD-10 Update:
ICD-10: Navigate Your Way Through a Plethora of Dens Fracture Choices
Confirm type of fracture and displacement.ICD-10 raises the stakes for your dens fracture ... Read more
HCPCS Update:
Apply These Tips to Strengthen Your Spinal Device Reporting
Report interspinous spacer as distraction device, spinal bone grafts as prosthetic implant... Read more
Reader Question:
Count Units of Service For 95938
Question: Can we bill two units of CPT® code 95938 (Short-latency somatosensory evok... Read more
Reader Question:
Know The Services Bundled in Craniotomy
Question: How do we bill the following procedure our surgeon did:\"Right temporal cranioto... Read more
Reader Question:
Earn For Cyberknife Done On Each Day
Question: Our surgeon is planning to do cyberknife procedure 61796 (Stereotactic radiosurg... Read more
Reader Question:
Look For Debridement in Gunshot Wound
Question Patient had a gunshot wound to the head, through and through with skull fragments... Read more
Reader Question:
Code For Each Cranial Procedure Your Surgeon Does
Question: Our neurosurgeon performed the below surgery:Revision left frontoparietal cranio... Read more
Reader Question:
Do Not Forget To Document Microscopic Visualization
Question: The diagnosis in the clinical note is as under:Right parafalcine 4 cm mass Mass ... Read more
Reader Question:
Report Spinal Hardware Injection as Unlisted
Question: How do we code for the spinal hardware injections?Alabama SubscriberAnswer: Your... Read more
Reader Question:
Confirm Inpatient Status for 22551, 22845
Question: We have received a denial for payment for CPT® code 20931 (Allograft, stru... Read more
Reader Question:
Confirm Code for Stem Cell Injection
Question: What is the correct CPT® code for lumbar stem cell injection and piriformi... Read more
You Be the Coder:
Be Clear on Electrode Array Counts
Question: Our surgeon's operative report reads \"bilateral 4-lead subcutaneous Medtronic f... Read more
Coding Tips:
Unlock Payment for Cranial And Spinal Procedures With Add-On Codes
Key: Apply these add-ons and watch your modifier 51 use.When reporting add-on codes, for y... Read more
ICD-10 Update:
ICD-10: Recast Your Late Effects of Cerebrovascular Disease Reporting
The additional digits call for more details and documentation.The current ICD-9-CM gives y... Read more
Coding Strategy:
E/M Coding Strategies: Tips Help You Select the Right Observation Codes Based on Time
Length of observation period is key to accurate reporting.When your surgeon places a patie... Read more
Reader Question:
Code 22630 Is Inclusive For Microdiscectomy and Facetectomy
Question: What codes should be used to code posterior lumbar interbody fusion at L4-5, com... Read more
Reader Question:
Look At Definitive Procedures to Report Dissection of Epidural Scar Tissues
Question: Please suggest a code for dissection of extensive epidural scar tissue.New York ... Read more
Reader Question:
Evaluate Postoperative Care for Modifier 55
Question: We have a neurosurgeon who performed a surgery on a patient and he is not part o... Read more
Reader Question:
Confirm Intent When Reporting Epidurogram
Question: How do we bill for epidurals? Is an epidurogram code 72275 (Epidurography, radio... Read more
Reader Question:
Confirm Tumor Pathology In Tumors
Question: Our surgeon did a biparietal, bifrontal craniotomy to bridge the sagittal sinus.... Read more
You Be the Coder:
Turn To Unlisted Code for Buttress Plate Attached To One Vertebra
Question: Our patient previously (in the past six months) had direct lateral interbody fus... Read more
Coding Tips:
Solve Your Dural Repair Coding Dilemmas With These Winning Pointers
Action: Confirm the reason for dural leak, grafting. If you're wondering how best to repor... Read more
What is the Dura?
The dura is the outermost layer of the three layers of meninges that surround the brain an... Read more
ICD-10 Update:
Learn These Easy Steps For Neurofibromatosis Reporting
Hint: Let disease type guide you to the right code.Neurofibromatosis may pop up as a diagn... Read more
CCI Update:
CCI 18.1 Update: You No Longer Report Selective Catheter Placement with Vessel Repair
Plus, you never can mix new compression codes with manipulation.Certain CPT® 2012 co... Read more
Reader Question:
Check for Hemorrhagic Complications in Cranial Metastases of Melanoma
Question: How can we report the proper diagnosis code for hemorrhagic melanoma with intrac... Read more
Reader Question:
Look For Specific Code to Report Synovial Cyst
Question: Our doctor is doing a synovial cyst resection at L4-5. The diagnosis code I have... Read more
Reader Question:
Confirm the Purpose of Fiducial Markers
Question: Our neurosurgeon did laminectomy for thoracic metastasis and removed epidural tu... Read more
Reader Question:
See How You Can Earn Benefits with Modifier 51
Question: We have multiple claims coming back from Medicare-Palmetto GBA with modifie... Read more
Reader Question:
Report 22595 and 22326 Together
Question: Please help us to understand if 22595 (Arthrodesis, posterior technique, atlas-a... Read more
Reader Question:
Code 22551 Includes Discectomy, Osteophytectomy, And Bone Removal
Question: We are billing a Medicare patient for "ACDIF & reconstruction requiring C3-C... Read more
You Be the Coder:
Evaluate the Closure with Craniectomy
Question: Our surgeon did the following procedure:PREOPERATIVE DIAGNOSIS: Right forehead s... Read more
Coding Strategies:
3 Questions You Need To Answer Before You Code Intracranial Hematomas
Site, location are your best guides. When your neurosurgeon performs hematoma evacuations ... Read more
ICD-10 Update:
Coding A Headache After Trauma? You Have A Huge Choice In Codes
Ask your surgeon for precise documentation and narrow down to the right code.When your sur... Read more
NCCI Edits 18.1:
Boost Your Payment For Spine Procedures
Append modifiers to grafts, open procedure, fracture reduction, and arthodesis with poster... Read more
Reader Question:
Use Unlisted Code for Shunt Reposition
Question: How can we report reposition or revision of pump and debridement of the abdomina... Read more
Reader Question:
Sacro-iliac Fusion Includes Bone Graft
Question: If the physician did posterior arthrodesis for achondroplasia and recurrent sten... Read more
Reader Question:
Don't Overlook Instrumentation in Spine Procedures
Question: Our surgeon did the following procedure:Removal of cervical plate C5-C7; anterio... Read more
Reader Question:
Code the Graft as Multiple Procedure in Cranial Repair
Question: How do we report the transsphenoidal tumor resection for a tumor in the sellar/s... Read more
Reader Question:
Look For Fluoroscopic Guidance with Paravertebral Injections
Question: Our surgeon does a right C2 parafacet and epidural steroid injections as well as... Read more
Reader Question:
Distinguish PLIF and PL for Each Level
Question: Is anyone else having issues getting 22614 (Arthrodesis, posterior or posterolat... Read more
Reader Question:
Append Modifier for Staged Procedure
Question: What CPT® should be used when the doctor brings back the patient a month a... Read more
Reader Question:
Omit Head Rests in Surgery
Question: We have a case where for posterior arthrodesis the doctor placed a Mayfield head... Read more
You Be the Coder:
Be Specific With Assistant Surgeon Services
Question: The office of our co-surgeon is requesting codes for ALIF. We provided code 2255... Read more
Coding Tips:
Downsize Your Craniomegalic Skull Reduction Challenges
Cranioplasty, bone grafts guide you to the right code. When your surgeon performs reductio... Read more
ICD-10 Update:
Upgrade Your Hydrocephalus Coding With These Tips
Spina bifida, congenital hydrocephalus map to more specific codes.When you report a commun... Read more
Modifier Basics:
Strategies Help You Distinguish Between Modifiers 58 And 78
Turn to condition, complication to make a choice.When reporting neurosurgical procedures, ... Read more
Reader Question:
Do Not Report Laminectomy Code With 63655
Question: Can we bill together for a laminectomy for decompression of nerve roots done at ... Read more
Reader Question:
Report Microdissection with Craniectomy
Question: For a patient diagnosed with left frontal basilar extra-axial tumor, our surgeon... Read more
Reader Question:
Look For Open Vs. Laparoscopic Revisions in Catheters
Question: Our neurosurgeon is doing a laparoscopic revision of distal catheter. Can we rep... Read more
Reader Question:
Closure of Lamina Is Bundled In 63268
Question: Patient has multiple Tarlov's Cysts (CSF filled sacs located on the spinal roots... Read more
You Be the Coder:
Choose Craniotomy Codes Over Skull Base Codes
Question: For the patient who was diagnosed a clinoidal meningioma, our surgeon did a ster... Read more
Coding Tips:
Banish Occipital Nerve Injection Headaches With These Strategies
Hint: Follow site of needle insertion to select the right code. When your physician treats... Read more
2012 Update:
Apply These New Instrumentation Updates For Spine Surgery
Do not report the removal codes with the insertion codes.According to CPT® 2012, you... Read more
ICD-10 Update:
Take a Sneak Peak at Correct Coding for Cerebral Emboli
Anatomical site, laterality, infarctions guide you to correct code.When ICD-10 hits, you w... Read more
Reader Question:
Check Extension in Extramedullary Tumors
Question: How do we report a suboccipital craniectomy and C1-3 laminectomy for removal of ... Read more
Reader Question:
Bill Dura Leaks in Spine Surgery
Question: Can we bill 62272 (Spinal puncture, therapeutic, for drainage of cerebrospinal f... Read more
Reader Question:
Use Unlisted Code for Endoscopically Assisted Rhizotomy
Question: How do we report when our surgeon does an endoscopically assisted medial branch ... Read more
Reader Question:
Code for Both Scar Revision and Re-Exploration if Applicable
Question: How can we report for excision of previous scar with skin margins and re-explora... Read more
You Be the Coder:
Do Not Report Fluoroscopy with Facet Injections
Question: Our provider bills the following:64493 (Injection[s], diagnostic or therapeutic ... Read more
CPT®2012 Update:
Tips Help You Ace Bone Biopsies With Vertebroplasties
Locate the levels for primary procedure and biopsy. Read in the procedure note if your sur... Read more
ICD-10 Update:
Expect to Expand Your Coding Options for Non-meningitic Complications of Herpes Zoster
Report the myelopathy, ganglionitis, neuropathy, and unspecified neurological complication... Read more
Coding Tips:
5 Major Add-On Codes Can Ease Your Cranial Procedures Coding
Never ignore the add-on procedure in a craniotomy.When reporting cranial procedures, you t... Read more
Reader Question:
Can You Report De-Rotation of Spine?
Question: What CPT® code do we use for "de-rotation of spine" done at the time of po... Read more
Reader Question:
Report Technique and Anastomosis for Moyamoya
Question: What CPT® code would be appropriate for frontal craniotomy for synangiosis... Read more
Reader Question:
Count Lumbar Levels in Laminectomy
Question: How do we report when the surgeon does a lumbar laminectomy with facetectomy/for... Read more
You Be the Coder:
Count Incisions and Not Aneurysms
Question: Can we code for two aneurysms when they are approached through the same incision... Read more
Coding Tips:
5 Tips Build Accuracy In Your Nerve Conduction Studies Reporting
Best practice: Look for the functional component and keep a close count on the nerve(s) tr... Read more
2012 Coding Update:
Revamp Your Arthrodesis Coding With These 2012 Changes
Know the bundling and learn the descriptor changes. You'll need to rethink how you're repo... Read more
Coding Guidelines:
You Are Mistaken If You Think All ICD-9 Codes Expand Into Multiple Options.
Report both acute and chronic conditions that your patient has.The ICD-10-CM manual seems ... Read more
Reader Question:
Look For Location in Spinal Fusions
Question: Do we report 22600 or 22610 for the fusion C7-T1?Florida SubscriberAnswer: This ... Read more
Reader Question:
Relate Global Period to Initial Procedure
Question: For a related procedure done in global period with modifier 78 attached, should ... Read more
Reader Question:
Do Not Report Separately For Wound Vac
Question: Our neurosurgeon did a VP shunt revision (62230) and placed a wound vac. Can we ... Read more
Reader Question:
Report 22851 When Fixation is Integral to Prosthetic Device Placement
Question: Our surgeons are using the LDR ROI-C plating system, which is a cage with two ar... Read more
Reader Question:
Use Unlisted Code for Pin Placement in SI Joint
Question: How do we report when the surgeon makes a 4 cm incision and then utilizes fluoro... Read more
Reader Question:
Do Not Bill Together For 63282 And 63283
Question: If the doctor removes a very large tumor from L4 to S2 can I bill 63282 and 6328... Read more
You Be the Coder:
Bill for Open Procedure in Paddle Placement
Question: Is this what I would use for this case? Patient has complex regional pain syndro... Read more
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