Neurosurgery Coding Alert

The newly released version 9.2 of the National Correct Coding Initiative (NCCI) classifies linear accelerator-based stereotactic radiosurgery as mutually exclusive of a host of neurosurgical procedures.

The newly bundled procedures include craniectomy/craniotomy 61304-61340, 61450-61500, 61510-61516, 61518-61524, 61530 and 61563-61564, as well as 61682 and stereotactic procedures 61735 and 61793. Billing any of the above with G0251 (Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment) would technically constitute a duplication of services and lead to a claim's rejection. Because G0251 represents a facility service, the intent of the edit is likely to reduce inadvertent billing for the professional component by hospitals.

Two additional edits bundle +61795 (Stereotactic computer assisted volumetric [navigational] procedure, intracranial, extracranial, or spinal [list separately in addition to code for primary procedure]) and +69990 (Microsurgical techniques, requiring use of operating microscope [list separately in addition to code for primary procedure]) to G0251. Therefore, you may not charge separately for 61795 or 69990 when reporting G0251.

Note: Version 9.2 of the NCCI for the third quarter of 2003 is effective July 1-Sept. 30. To view a complete list of the new ICD-9 codes and their related DRG groups, go to http://a257.g.akamaitech.net/7/257/2422/14mar20010800/edocket.access.gpo.gov/2003/03-11966.htm.