Neurosurgery Coding Alert
Choose 61210 for Frontal Ventriculostomy
Question: What is the correct code for right frontal ventriculostomy? The operative report states that the surgeon drilled a single trephine, tapped the right frontal horn and inserted a Becker ventricular catheter. Answer: In this case, report 61210* (Burr hole[s]; for implanting ventricular catheter, reservoir, EEG electrode[s] or pressure recording device [separate procedure]). Although this code does not specifically mention trephination, several codes in this section (for instance, 61140-61151, Burr hole[s] or trephine ...; and 61250, Burr hole[s] or trephine, supratentorial, exploratory, not followed by other surgery, and others) bundle burr holes and trephination, which are similar in size and degree of difficulty.
Virginia Subscriber
The only other code choice, 61107* (Twist drill hole for subdural or ventricular puncture; for implanting ventricular catheter or pressure recording device), specifies "twist drill hole" only. A twist drill hole differs more significantly from trephination than does a burr hole. For instance, nowhere in this section does CPT bundle twist drill hole and trephine as it does burr hole and trephine. Therefore, 61107 is not the best choice.
Neurosurgery Coding Alert
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Choose 61210 for Frontal Ventriculostomy
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