Neurosurgery Coding Alert

Question: Our neurosurgeon used the operating microscope for visualization when he clipped a small anterior communicating artery aneurysm with microdissection technique. Which codes apply to this?

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Answer: When your surgeon uses the operating microscope for microdissection, you report the microdissection code +69990 (Microsurgical techniques, requiring use of operating microscope [List separately in addition to code for primary procedure]) in addition to the code for the primary procedure (61700, Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation). You'll report code +69990 only once for the session.

You should look for terms like Weck, Zeiss, or Leica operating microscope in the operative note to confirm the utilization of an operating microscope. In addition, the surgeon should document the performance of microdissection to support use of 69990.