Neurosurgery Coding Alert

Make note of codes that you need to delete from your list.

It’s now time to update your coding content for 2015. In a few months from now, you should know which neurosurgery codes you can no longer report. Here is a quick update for the codes that will be deleted in 2015.

Check These Craniotomy/Craniectomy Codes

Effective 2015, you will not report the following craniotomy codes:

• 61440, Craniotomy for section of tentorium cerebelli (separate procedure)
  
• 61490, Craniotomy for lobotomy, including cingulotomy
  
• 61542, Craniotomy with elevation of bone flap; for total hemispherectomy
  
• 61470, Craniectomy, suboccipital; for medullary tractotomy
  
• 61875, Craniectomy for implantation of neurostimulator electrodes, cerebellar; subcortical
  

The main reason for deletions of these craniotomy/craniectomy codes that the frequency of these procedures decreased in clinical practice. Your neurosurgeon may very rarely perform procedures like cingulotomy which was introduced in 1952 for last resort of managing obsessive compulsive disorders or chronic pain. Your neurosurgeon may rarely do a total hemispherectomy, a procedure in which half of the brain is removed or disabled. This is because your surgeon now has more advanced options of managing conditions like epilepsy with a broad area of foci of origins.

Also Strike Off 3 More Codes

In 2015, you will have three additional codes that you can strike off your list. These include the following:

• 62116, Reduction of craniomegalic skull (e.g., treated hydrocephalus); with simple cranioplasty
  
• 61334, Exploration of orbit (transcranial approach); with removal of foreign body
  
• 61609, Transection or ligation, carotid artery in cavernous sinus; without repair (List separately in addition to code for primary procedure)
  

Rationale: “During the past year, the CPT® Editorial Panel reviewed CPT® codes which were reported five or fewer times to Medicare over the preceding year,” says Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center, Edison. “AMA staff also queried third party payer and Medicaid databased to determine whether these same codes were being reported infrequently.  If the CPT® code utilization was low among all of these entities, the specialty societies were contacted to determine whether there was an objection to deleting these codes.   Consequently, the codes listed above were deleted for 2015.  Typically, similar CPT® codes remain available and have been used more commonly in comparison to the deleted codes.”