Neurosurgery Coding Alert
Check for Neurolytic Destruction in Trigeminal Block
Question: Our surgeon did a fluoroscopy guided glycerol rhizotomy in the Meckel’s cave. Which code can we use to report the above procedure? If 64600 is the correct code, would I code fluoroscopy code?
Answer: Your surgeon is likely doing a neurolytic procedure on the Gasserian ganglion. You should report the percutaneous stereotactic alcohol lesion of the gasserian ganglion using 61790 (Creation of lesion by stereotactic method, percutaneous, by neurolytic agent…) if fluoroscopy is used for stereotactic localization. If your surgeon performs a neurolysis without stereotactic localization, you’ll report 64610 (Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring). According to the CPT® parenthetical note, the destruction codes, 64600–64681 (Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus), are inclusive of injection of other therapeutic agents (such as, corticosteroids).
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Neurosurgery Coding Alert
- June 2013:
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