Neurosurgery Coding Alert

Question: Our neurosurgeon did laminectomy for thoracic metastasis and removed epidural tumor. He then placed six fiducial markers. Is there a code that we can report for our neurosurgeon placing the fiducial markers?

Ohio Subscriber

Answer: Your question did not describe the purpose of placing the fiducial markes. The placement of fiducials may be part of another procedure and therefore not reported separately. If it is not part of another primary procedure but will be used for localization purposes in a future procedure, you may be able to report placement of fiducial markers with the unlisted code 64999 (Unlisted procedure, nervous system). If the markers were placed to perform stereotactic navigation during the procedure, you should actually be looking at stereotactic navigation. In such an instance, you report code 61783 (Stereotactic computer-assisted [navigational] procedure; spinal [List separately in addition to code for primary procedure]).