Neurosurgery Coding Alert

Question: Can we bill for a biopsy at the same time as placing a gliadel wafer? If so, can we code as 61770 and 61751-52-51?

Florida Subscriber

Answer: Code 61770 is for brachytherapy, not the placement of gliadel wafers. There is no specific code for the insertion of this as it is considered by Medicare and most third-party payers to be included in the 61751 (stereotactic biopsy, aspiration, or excision, including burr hole[s], for intracranial lesion; with computerized axial tomography and/or magnetic resonance guidance). If the insertion added time and effort to the procedure, you may bill 61751 appended with modifier -22 (unusual procedural services) to reflect that. Modifiers -51 (multiple procedures) and -52 (reduced services) are not necessary because they would only be attached to a secondary code, which is not needed in this case.