Neurosurgery Coding Alert

Question: I’m confused by what the different tumor approaches mean. Can you please explain them to me?

Florida Subscriber

Answer: Transcranial approach: The neurosurgeon may adopt a transcranial approach to the orbit to approach tumors located in the orbital apex and/or optic canal. The neurosurgeon may also use the transcranial approach for tumors that involve both the orbit and adjacent intracranial areas. Transcranial approaches include fronto-orbital, fronto temporo-orbital, subfrontal, or pterional approaches.

Small frontal or frontotemporal craniotomy: For limited lesions, the neurosurgeon may do a small frontal or frontotemporal craniotomy, with removal of the orbital roof and/or lateral wall of the orbit.

Orbitofrontal or orbitozygomatic approach: For larger tumors, the neurosurgeon may adopt an orbitofrontal or orbitozygomatic approach along with the elevation of the orbital rim with the bone flap.