Neurosurgery Coding Alert

Question: Our surgeon made a percutaneous puncture to do a simple irrigation of the ventricular catheter. At the same time, he also made another exposure to revise the distal catheter through a separate exposure. Can we report code 62230 and 61070?

California Subscriber

Answer: You report code 61070 (Puncture of shunt tubing or reservoir for aspiration or injection procedure) for percutaneous ventricular catheter irrigation and 62230 (Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system) for replacement of the distal catheter.

Watch for the bundle: Note that Correct Coding Initiative (CCI) column 2 edits exist for 61070 and 62230, so you’ll append modifier 59 (Distinct procedural service) to 61070 if you report this code with 62230. If ventricular catheter irrigation is performed through the same exposure as the distal shunt revision, then this would be considered a bundled service.