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Neurosurgery Coding Alert

Coding Case:
Look to These Key Strategies to Finesse Your Ventriculoperitoneal Shunt Tap Coding
Hint: Keep an eye out for additional procedures, radiological supervision. When your n... Read more
ICD-10:
Simplify Reporting For Malignant Meningeal and Spinal Cord Tumors
Be specific for spinal cord, cauda equina, and meninges. When reporting a diagnosis of... Read more
Billing Corner:
Advice Dispels 5 Common ABN Myths
Make sure you know when Medicare never pays. Buying into common misconceptions about a... Read more
Reader Question:
63047 Is Inclusive Of Dural Repair
Question: A patient who had a previous laminectomy reported to the ER with a CSF and our... Read more
Reader Question:
Do Not Report Laminectomy With 61343
Question: What is the correct CPT® code for a revision of craniectomy? The pati... Read more
Reader Question:
ICD-10 Will Offer Specific Options for Spondylolisthesis
Question: What is the correct ICD-9 code for cervical spondylolisthesis? Answer:&... Read more
Reader Question:
Turn To 63200 for Tethered Cord
Question In a patient with tethered cord at T9-T10 with scar tissue at T12-L1, our ... Read more
Reader Question:
Dig Deep for Discontinued Procedures
Question The patient presents for a 6-month follow-up following coiling of a right ... Read more
Reader Question:
Do Not Report Catheterization With 61626
Question: Our surgeon performed a transvenous venogram of the left subclavian vein ... Read more
Reader Question:
Do Not Overlook Any Relevant History
Question We are currently working for a neurosurgeon who saw a patient for consulta... Read more
You Be the Coder:
Accurately Code Vertebral Fractures
Question: One of the patients treated by our neurosurgeon had a pathologic fracture of L... Read more
Crack Your Depressed Skull Fracture Coding Challenges With These Strategies
Confirm if a simple, compound, or comminuted fracture was repaired. You’ll be we... Read more
Adopt These Best Practices for Billing For Same-Day E/M Encounters
Be sure of when you can and when you can’t report multiple codes. Your provider ... Read more
Gain Precision In Reporting Diagnosis Codes For Parkinsonism
Avoid symptom centricity and choose a specific code. ICD-10 brings several new Parkins... Read more
Reader Question:
Report 63271 for Intradural Approach
Question: How do we report a T3-T9 thoracic laminectomy for removal of intradural/e... Read more
Reader Question:
Check for Bundle in 63709 And 63047
Question: A patient came to the ER with a CSF leak from a previous laminectomy. Our... Read more
Reader Question:
Assign 63045 for C1 Laminectomy
Question: Our surgeon did a suboccipital craniectomy and C1 laminectomy for resecti... Read more
You Be the Coder:
Correctly Report Revision of a Cranioplasty
Question: What is the correct CPT® code for a revision of craniectomy? The pati... Read more
Simplify Your Stereotactic Surgery Reporting With This Expert Advice
Learn the difference between “pallidotomy” and “thalamotomy.” ... Read more
When Do You Turn To Stereotactic Procedure Codes?
Stereotactic procedures use minimally invasive approaches. You should look for stereotac... Read more
Diagnosis Coding:
3 Tips Clarify Your Concussion Management Coding
Remember to take into account late effects codes. If you’re scratching your head... Read more
CPT® 2014:
Recaculate How You Report Chemodenervation Services As of Jan.1
Find out how the number of muscles in the limbs and trunk the physician denervates matte... Read more
Reader Question:
Check Global Period for Device Repositioning
Question: Our surgeon performed surgical revision of L2 and L3 pedicle screws. In a... Read more
Reader Question:
Check If You Can Additionally Report Laminectomy
Question: The patient being treated by our surgeon hit a bump in the road and she f... Read more
Reader Question:
Turn For Unlisted For Percutaneous Balloon Decompression in Trigeminal Neuralgia
Question: What is the correct CPT® code for percutaneous balloon decompression ... Read more
Reader Question:
Check with Payer for Angioplasty without Stent
Question: Can you suggest a code for an extracranial angioplasty of internal caroti... Read more
You Be the Coder:
Code for Drain and Follow Up
Question: Our surgeon placed a lumbar drain and this was left intact for several da... Read more
6 Top Tips Boost Your Unlisted Procedure Billing
Hint: Provide supporting explanation and procedure comparisons. Have no choice but to rep... Read more
ICD-10 Update:
Avoid Stress In Coding For Quadriplegia
Levels guide your diagnosis coding in ICD-9 and ICD-10. You’ll stand a better ch... Read more
What Is Quadriplegia?
The term quadriplegia, is derived from the Latin term ‘quad’ meaning four an... Read more
Reporting Vertebroplasty? Check AMA Guidelines Versus Medicare's Rules
Hint: Focus on vertebral locations before you decide on any additional codes. The AMA an... Read more
Reader Question:
Pick Up Specific Codes for Meningioma Excision
Question: Our surgeon did a craniotomy for resection of skull base medial sphenoid wing ... Read more
Reader Question:
Look At 63265 for Cervical Epidural Abscess Evacuation
Question: In a patient who was diagnosed with a cervical epidural abscess in C6-T2, our ... Read more
Reader Question:
Report 62365 for Pain Pump Removal
Question: Our neurosurgeon removed an implanted pain pump and catheter from. a patient w... Read more
Reader Question:
Be Specific For Tumor Excision in Spine
Question: In a patient diagnosed with a tumor at T12, our surgeon adopted a retroperiton... Read more
You Be the Coder:
Should You Bill 63056 and 63047 Together?
Question: If our surgeon does a transpedicular discectomy and a redo laminectomy, medial... Read more
2 Steps Improve Your Transcranial Approach To Orbit Accuracy
Tip: Confirm craniotomy and procedure for orbital pathology. When your neurosurgeon ac... Read more
Review These Tumor Approach Basics
Your surgeon may adopt a transcranial approach to the orbit to approach tumors located i... Read more
Boost Your Confidence For Balloon Dilatation Of Vasospastic Narrowing
Always report multiple attempts and multiple dilatations. When reporting balloon dilat... Read more
ICD-10 Update:
Levels guide your codes for spinal lesions accompanying closed cervical fractures
In ICD-10, you look for individual codes for fracture and spinal injury. You need to e... Read more
Reader Question:
Count Interspaces in Laminotomy
Question: Please elaborate the appropriate way to bill a Bilateral Revision Decompressiv... Read more
Reader Question:
You May Report Multiple Units For Aneurysm Clipping
Question: Our surgeon did a craniotomy and placed a clip over a large anterior communica... Read more
Reader Question:
Earn For Each Level in Vertebroplasty
Question: How do we report vertebroplasty at level T10 to L2? Do we report level L1 as a... Read more
Reader Question:
Check Extent of Exploration in Meningioma Resection
Question: Surgery in a patient who had petroclival meningioma lasted more than 12 hours.... Read more
You Be the Coder:
Be Precise for Skull Tumor Resection
Question: How do we report right parieto-occipital craniotomy for resection of mass and ... Read more
Defuse Your Intracranial Balloon Angioplasty Coding Stress
Hint: Confirm stenting, do not additionally report inclusive services. You’ll be... Read more
ICD-10:
Don't Be Dismayed By Demyelinating Disorder Codes
Check all options you have before selecting a single code. When reporting ICD-10 codes... Read more
Practice Management:
Make Your Way To Successful Incident-To Billing With These Tips
Auxiliary staff can bring in the payment if CMS requirements are met. If your neurosur... Read more
Reader Question:
22612 Vs 22633 for Lumbar Arthrodesis
Question: Could you please explain the difference between codes 22612 and 22633? Cod... Read more
Reader Question:
Take the Right Path for Temporal Lobe Resection
Question: How do we report a temporal lobe resection for uncal herniation with the uncus... Read more
Reader Question:
You Can Report Multiple Units Of 61624
Question: How would you code coil embolization of two aneurysms, one of the left PCOM an... Read more
Reader Question:
Count Spinal Levels for Epidurals
Question: Our surgeon administered transforaminal epidural injections at L4/L5 and L5/S1... Read more
Reader Question:
Count the Number of Subdural Taps
Question: How do we report a subdural tap through the anterior fontanelle done for an in... Read more
You Be the Coder:
Earn For Every Step in Neurosurgery
Question: Our surgeon did a ventriculoscopy and fenestrated a cystic tumor in the third ... Read more
June 2013:
Tactics Assist Your Neuroendoscopy Accuracy
Hint:  Identify the reason for the neuroendoscopy. The key to correctly coding ne... Read more
ICD-10:
Location Specifics Drive Your Brain Tumor Code Selection
Look at brainstem code for tumor in fourth ventricle. A sneak peek into the ICD-10 opt... Read more
Follow These Strategies To Make Strong Appeals For Modifier 25
Hint: Always keep a tab on global period assignments. Don’t be disheartened if y... Read more
Reader Question:
Wrap Arthrodesis, Instrumentation into Cervical Laminoplasty
Question: How can we bill a cervical laminoplasty C3-C7 with synovial cyst removal at C3... Read more
Reader Question:
Report 63005 for Lumbar Laminectomy
Question: Our surgeon performed complete laminectomy for decompression of dura at L2 whe... Read more
Reader Question:
Check for Neurolytic Destruction in Trigeminal Block
Question: Our surgeon did a fluoroscopy guided glycerol rhizotomy in the Meckel’s ... Read more
Reader Question:
File an Appeal for Spinal Bone Grafts
Question: We seek help in writing an appeal letter for nonpayment of two graft codes, 2093... Read more
Reader Question:
Tally Your Laminectomy Levels
Question: If a surgeon states in the operative note dictation that they did a lumbar lam... Read more
You Be the Coder:
Count Incisions in Brain Tumor Removal
Question: If our surgeon does a craniectomy with 1 bone flap and does separate incisions... Read more
Coding Strategy:
Don't Let Nerve Repair Unnerve You
Top tip: Count nerves, not sutures. Nerve repair may be a simple procedure but reporti... Read more
Coding Tips:
Conquer Coding Challenges in Coding Neurostimulator Devices and Arrays
Check for cortical, subcortical, and cerebellar locations; count arrays. You can downs... Read more
Practice Tips:
Considering EMRs For Your Practice? Here Is What You Need To Know
Weigh the pros and cons to pick up and implement the best system. Ever wondered what y... Read more
Reader Question:
Check for Levels in Spinal Procedures
Question: Our neurosurgeon did T6 and T7 vertebral corpectomies with T6-7, T5-T6 and T7-... Read more
Reader Question:
Confirm Area of Excision in Lumbar Keloid
Question: For patient who had a LP shunt placed few months ago, our surgeon did an explo... Read more
You Be the Coder:
Do Not Ignore Time for Neurostimulator Programming
Question: Our surgeon implanted a Vagal Nerve Stimulator and documented electronic analy... Read more
Coding Tips:
Unlock Spinal Cage Coding With These Tips
Hint: Streamline coding by counting interspaces and not devices. You can avoid spinal... Read more
ICD-10 Update:
Chill Out Over Unruptured Intracranial Aneurysms
Cause is important in congenital aneurysms, location in others. When reporting nonrupt... Read more
Coding Strategy:
Expert Advice Helps You Understand Spinal Epidurals
Check the diagnosis and where the needle is positioned. When your surgeon provides ep... Read more
Reader Question:
Confirm Supporting Reason for Modifier 79
Question: Our surgeon performed radiofrequency procedure and we reported it with code 64... Read more
Reader Question:
Turn To Unlisted For Urethral Plexus Anastomosis
Question: We need help for the right code for the harvest of a sural nerve graft which w... Read more
Reader Question:
Confirm Spinal Levels in Laminectomy
Question: We are claiming for a patient with Ewings Sarcoma at L1 and a pathologic fract... Read more
Reader Question:
Count Segments and Interspaces In Lumbar Procedures
Question: On Jan 3, 2013, our surgeon did a laminectomy for stenosis on L2,3,4 and 5 whi... Read more
Reader Question:
Count Each Step and Instrument in Cervical Fusion
Question: Our surgeon performed 3 procedures for cervical fusion to fix a kyphotic cervi... Read more
You Be the Coder:
Use Brain Tumor Codes for Vestibular Schwannoma Excision
Question: How do we report a retromastoid craniotomy for resection of a vestibular schwa... Read more
Coding Strategies:
5 Key Steps Pave The Way To Spinal Instrumentation Claims Success
Hint: Verify location, determine span, and append modifiers. If coding spinal instrume... Read more
ICD-10 Update:
ICD-10 Switch Is Simple For Intracranial And Intraspinal Abscesses
You have a one-to-one match with ICD-9 codes. For intracranial and intraspinal abscess... Read more
Coding Tips:
Improve Your Intracranial Aneurysm Codings With This Refresher
Complexity of aneurysm and not the surgical procedure guides your choice of codes. Kno... Read more
Distinguish Intracranial Aneurysms:
Simple vs Complex
To submit the right codes, you need clarity on how to distinguish a simplex and complex ... Read more
Reader Question:
Don't Overlook Complications of Pineal Mass Excision
Question: Our surgeon did a parietal craniotomy for removal of a pineal mass. The comple... Read more
Reader Question:
Check for Segments in Spinal Decompression
Question: Our surgeon did a complete microdiscectomy between T7 and T8 to remove the dis... Read more
Reader Question:
Count Interspaces for Microlaminotomy and PLF
Question: How do we code for two levels where our surgeon did microlaminotomies and PLF ... Read more
You Be the Coder:
22856 And 0309T Are Not Bundled In 2013
Question: Can you please advise whether we should report the new 2013 CPT® codes &ls... Read more
Coding Case Study:
Adopt This Stepwise Approach to Improve Your Spinal Procedures Results
Key: Report all procedures and levels to earn full payment. Spinal procedures can seem... Read more
Coding Tips:
3 Common Examples Help You Finesse Post-Op Infection Coding
Hint: Confirm the global period and don’t forget the modifiers. When reporting p... Read more
Billing Corner:
Make Sure You're Implementing These E/M Coding Changes
Know who can now render services and who can bill for services. 2013 brought E/M descr... Read more
Reader Question:
Count Regions for Laminectomy
Question: For bilateral removal of a spinal metastatic tumor, our surgeon did a thoracic... Read more
Reader Question:
Submit 61520 for Vestibular Schwannoma
Question: Is the code 61510 (Craniectomy, trephination, bone flap craniotomy; for excisi... Read more
Reader Question:
Use Modifiers for Repeat Procedures
Question: The patient underwent laminectomy, 63047 (Laminectomy, facetectomy and foramin... Read more
Reader Question:
Determine Contributions of Each Surgeon in Complex Cases
Question: In the patient diagnosed with recurrent meningioma of right cavernous sinus in... Read more
Reader Question:
Choose 62143 for Carniectomy Plates
Question: Our surgeon performed a right parietal craniotomy, open biopsy, placed a Mayfi... Read more
Reader Question:
Use Specific Codes to Report Laminectomy Complications
Question: The patient who underwent a lumbar laminectomy on 14 Nov 2012, developed heada... Read more
Reader Question:
Check for Tethered Cord Release
Question: What code(s) can we report for tethered spinal cord syndrome? New York Sub... Read more
Reader Question:
Debridement is Guided by Extent
Question: What CPT® code can we use for debridement of craniotomy wound infection do... Read more
You Be the Coder:
Report Retained Spinal Needle Removal as Unlisted
Question: When trying to accomplish an epidural anesthetic, the spinal needle broke off ... Read more
Coding Case Study:
Perfect Your Chiari Malformation Coding Skills With This Advice
Hint: Confirm spinal decompression, check documentation for any additional procedures. ... Read more
Coding Tips:
2 Tips For Flawless Claims For Post-Op Infections
Check with your payer and append correct modifiers. If you’re assuming you alway... Read more
Coding Strategies:
Are You Leaving Behind Payment For Laceration Repairs?
Key: Check laceration size and report the office visit. When your surgeon evaluates an... Read more
Reader Question:
Separate ED Services and Lumbar Procedure
Question: Our neurologist did a spinal tap for a patient who reported to the ED with pai... Read more
Reader Question:
Confirm Location for CSF Leak
Question: Our surgeon reopened the suboccipital region were there was a small pseudomeni... Read more
Reader Question:
Deep I&D Is Inclusive Of Superficial Drainage
Question: Our surgeon opened a cystic wall to drain a fluid collection in the lumbar spi... Read more
Reader Question:
Append the Right Modifiers for Bilateral Injections
Question: We have been facing challenges for reporting bilateral procedures like injecti... Read more
Reader Question:
Confirm Contribution in Cosurgery
Question: Our surgeon did a cerebrospinal fluid repair during a radical mastoidectomy pe... Read more
You Be the Coder:
Never Forget Instrumentation in Spine Surgery
Question: How do we code a C1-C5 laminectomy with stealth sequence, occiput lateral mass... Read more
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