Neurosurgery Coding Alert

Question: Can we bill codes 62225 (Replacement or irrigation, ventricular catheter) and 62230 (Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system) for a ventriculoperitoneal shunt during the same session?

Ohio Subscriber

Answer: The two procedures described deal with the proximal and distal portions of the ventriculoperitoneal catheter respectively. If both the ventricular catheter and the distal catheter are replaced, then the appropriate code to report is 62258 (Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation). If the ventricular catheter is simply irrigated through a percutaneous puncture and the distal catheter is revised through a separate exposure, one may report 62230 and code 61070 (Puncture of shunt tubing or reservoir for aspiration or injection procedure)-59 (Distinct procedural service) for percutaneous ventricular catheter irrigation. Note that CCI column 1 edits (requires modifier for procedures considered typically bundled) exist for 61070 and 62230. If ventricular catheter irrigation is performed through the same exposure as the distal shunt revision, then this would be considered a bundled service.