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Neurosurgery Coding Alert
Neurosurgery Coding Alert
Neurosurgery Coding Alert - 2012; Volume 13, Number 12
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...
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Coding Tips:
4 Tips Strengthen Your Spinal Catheter Reporting
Hint: Code for tunneled vs non-tunneled approach; check for follow-up. Spinal catheters...
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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...
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Brush Up on Laminectomy Basics
The lamina is the posterior arch of the vertebral bone. The lamina lies between the spin...
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Reader Question:
Earn For Redo Spinal Procedures
Question: How do we report the following? Decompressive Laminectomies Total L3, parti...
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Reader Question:
Check Bundle In Device Removal and Laminectomy
Question: How do we report the procedures described in the operative note below: "The p...
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Reader Question:
Confirm Site of Graft Harvest
Question: How do we bill for right temporal craniotomy with reconstruction of skull base...
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Reader Question:
Report Spinal Bone Stimulator Removal as Unlisted
Question: What is the correct CPT® code for the removal of a spinal bone stimulator?...
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Reader Question:
Remove Your Doubts for Drain Removal
Question: Surgeon A performed a posterolateral fusion, laminectomy, and pedicle screw in...
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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...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 11
Coding Case:
Strengthen Your Spinal Reporting With This Stepwise Approach
Consider discectomy and facetectomy bundled in interbody fusion.Spinal coding may pose a c...
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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...
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Basics of Brain Circulation
The main arteries that supply the brain include the vertebral arteries, basilar artery, an...
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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...
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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...
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Reader Question:
Count Levels for Laminectomy
Question: How do we report decompression laminectomy at L4-L5? Do we count this as two lev...
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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...
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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...
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Reader Question:
Check Components of Ventricular Catheters
Question: Can we bill codes 62225 (Replacement or irrigation, ventricular catheter) and 62...
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Reader Question:
You Have Limited Options For Spinal Subdural Hematoma
Question: What is the ICD 9 code for lumbar subdural hematoma?Missouri SubscriberAnswer: T...
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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...
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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?...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 10
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 ...
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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...
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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...
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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...
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Reader Question:
Do Not Report Burr Holes For Ventriculoperitoneal Pump
Question: One of our surgeons is looking at placing a "VENTRICULO-PERITONEAL" baclofen pum...
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Reader Question:
Earn For Every Level In Spinal Fusion
Question: Our surgeon does a T10-L2 posterior lumbar fusion in addition to open vertebropl...
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Reader Question:
Get Specific for Instrumentation and Grafts in Spinal Procedures
Question: Our surgeon did the following procedures using the posterior thoracolumbar ...
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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...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 9
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...
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Coding Tips:
4 Best Practices Ethically Maximize Your Microsurgery Reimbursement
Identify primary procedure and bundles -- and watch the units you report.Reporting yo...
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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...
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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,...
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Reader Question:
Circumvent Denials for 22845 with Discectomy
Question: Patient had anterior cervical discectomy and fusion (ACDF) at C4-6 and had previ...
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Reader Question:
Code Each Level of Cervical Spinal Procedures
Question: Our surgeon recorded the following procedures.Preoperative diagnoses:C2 arthriti...
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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...
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You Be the Coder:
Check If Your Surgeon Is Decompressing Nerves
Question: Would the appropriate code for a retrosigmoid suboccipital craniectomy for mass ...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 8
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...
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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...
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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 ...
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HCPCS Update:
Apply These Tips to Strengthen Your Spinal Device Reporting
Report interspinous spacer as distraction device, spinal bone grafts as prosthetic implant...
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Reader Question:
Count Units of Service For 95938
Question: Can we bill two units of CPT® code 95938 (Short-latency somatosensory evok...
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Reader Question:
Know The Services Bundled in Craniotomy
Question: How do we bill the following procedure our surgeon did:\"Right temporal cranioto...
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Reader Question:
Earn For Cyberknife Done On Each Day
Question: Our surgeon is planning to do cyberknife procedure 61796 (Stereotactic radiosurg...
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Reader Question:
Look For Debridement in Gunshot Wound
Question Patient had a gunshot wound to the head, through and through with skull fragments...
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Reader Question:
Code For Each Cranial Procedure Your Surgeon Does
Question: Our neurosurgeon performed the below surgery:Revision left frontoparietal cranio...
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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 ...
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Reader Question:
Report Spinal Hardware Injection as Unlisted
Question: How do we code for the spinal hardware injections?Alabama SubscriberAnswer: Your...
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Reader Question:
Confirm Inpatient Status for 22551, 22845
Question: We have received a denial for payment for CPT® code 20931 (Allograft, stru...
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Reader Question:
Confirm Code for Stem Cell Injection
Question: What is the correct CPT® code for lumbar stem cell injection and piriformi...
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You Be the Coder:
Be Clear on Electrode Array Counts
Question: Our surgeon's operative report reads \"bilateral 4-lead subcutaneous Medtronic f...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 7
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...
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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...
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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...
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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...
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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 ...
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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...
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Reader Question:
Confirm Intent When Reporting Epidurogram
Question: How do we bill for epidurals? Is an epidurogram code 72275 (Epidurography, radio...
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Reader Question:
Confirm Tumor Pathology In Tumors
Question: Our surgeon did a biparietal, bifrontal craniotomy to bridge the sagittal sinus....
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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...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 6
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...
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What is the Dura?
The dura is the outermost layer of the three layers of meninges that surround the brain an...
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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...
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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...
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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...
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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...
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Reader Question:
Confirm the Purpose of Fiducial Markers
Question: Our neurosurgeon did laminectomy for thoracic metastasis and removed epidural tu...
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Reader Question:
See How You Can Earn Benefits with Modifier 51
Question: We have multiple claims coming back from Medicare-Palmetto GBA with modifie...
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Reader Question:
Report 22595 and 22326 Together
Question: Please help us to understand if 22595 (Arthrodesis, posterior technique, atlas-a...
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Reader Question:
Code 22551 Includes Discectomy, Osteophytectomy, And Bone Removal
Question: We are billing a Medicare patient for "ACDIF & reconstruction requiring C3-C...
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You Be the Coder:
Evaluate the Closure with Craniectomy
Question: Our surgeon did the following procedure:PREOPERATIVE DIAGNOSIS: Right forehead s...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 5
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 ...
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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...
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NCCI Edits 18.1:
Boost Your Payment For Spine Procedures
Append modifiers to grafts, open procedure, fracture reduction, and arthodesis with poster...
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Reader Question:
Use Unlisted Code for Shunt Reposition
Question: How can we report reposition or revision of pump and debridement of the abdomina...
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Reader Question:
Sacro-iliac Fusion Includes Bone Graft
Question: If the physician did posterior arthrodesis for achondroplasia and recurrent sten...
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Reader Question:
Don't Overlook Instrumentation in Spine Procedures
Question: Our surgeon did the following procedure:Removal of cervical plate C5-C7; anterio...
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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...
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Reader Question:
Look For Fluoroscopic Guidance with Paravertebral Injections
Question: Our surgeon does a right C2 parafacet and epidural steroid injections as well as...
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Reader Question:
Distinguish PLIF and PL for Each Level
Question: Is anyone else having issues getting 22614 (Arthrodesis, posterior or posterolat...
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Reader Question:
Append Modifier for Staged Procedure
Question: What CPT® should be used when the doctor brings back the patient a month a...
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Reader Question:
Omit Head Rests in Surgery
Question: We have a case where for posterior arthrodesis the doctor placed a Mayfield head...
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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...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 4
Coding Tips:
Downsize Your Craniomegalic Skull Reduction Challenges
Cranioplasty, bone grafts guide you to the right code. When your surgeon performs reductio...
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ICD-10 Update:
Upgrade Your Hydrocephalus Coding With These Tips
Spina bifida, congenital hydrocephalus map to more specific codes.When you report a commun...
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Modifier Basics:
Strategies Help You Distinguish Between Modifiers 58 And 78
Turn to condition, complication to make a choice.When reporting neurosurgical procedures, ...
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Reader Question:
Do Not Report Laminectomy Code With 63655
Question: Can we bill together for a laminectomy for decompression of nerve roots done at ...
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Reader Question:
Report Microdissection with Craniectomy
Question: For a patient diagnosed with left frontal basilar extra-axial tumor, our surgeon...
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Reader Question:
Look For Open Vs. Laparoscopic Revisions in Catheters
Question: Our neurosurgeon is doing a laparoscopic revision of distal catheter. Can we rep...
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Reader Question:
Closure of Lamina Is Bundled In 63268
Question: Patient has multiple Tarlov's Cysts (CSF filled sacs located on the spinal roots...
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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...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 3
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...
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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...
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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...
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Reader Question:
Check Extension in Extramedullary Tumors
Question: How do we report a suboccipital craniectomy and C1-3 laminectomy for removal of ...
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Reader Question:
Bill Dura Leaks in Spine Surgery
Question: Can we bill 62272 (Spinal puncture, therapeutic, for drainage of cerebrospinal f...
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Reader Question:
Use Unlisted Code for Endoscopically Assisted Rhizotomy
Question: How do we report when our surgeon does an endoscopically assisted medial branch ...
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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...
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You Be the Coder:
Do Not Report Fluoroscopy with Facet Injections
Question: Our provider bills the following:64493 (Injection[s], diagnostic or therapeutic ...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 2
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...
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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...
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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...
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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...
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Reader Question:
Report Technique and Anastomosis for Moyamoya
Question: What CPT® code would be appropriate for frontal craniotomy for synangiosis...
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Reader Question:
Count Lumbar Levels in Laminectomy
Question: How do we report when the surgeon does a lumbar laminectomy with facetectomy/for...
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You Be the Coder:
Count Incisions and Not Aneurysms
Question: Can we code for two aneurysms when they are approached through the same incision...
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Neurosurgery Coding Alert - 2012; Volume 13, Number 1
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...
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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...
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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 ...
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Reader Question:
Look For Location in Spinal Fusions
Question: Do we report 22600 or 22610 for the fusion C7-T1?Florida SubscriberAnswer: This ...
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Reader Question:
Relate Global Period to Initial Procedure
Question: For a related procedure done in global period with modifier 78 attached, should ...
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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 ...
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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...
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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...
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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...
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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...
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