Neurosurgery Coding Alert

Question: What CPT® code can we submit for the use of the O-Arm system during spinal surgery for placement of instrumentation? Our physician also does a 3-D CT imaging. Is it appropriate to report code 61783? 

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Answer: The O-Arm system is typically used with a computer-assisted navigation system but the system can also be used as a standalone as an intraoperative CT scanner. You can typically report O-Arm with the CT imaging code +61783 (Stereotactic computer-assisted [navigational] procedure; spinal [List separately in addition to code for primary procedure]) with appropriate fluoroscopy code. CPT® 61783 describes the work in pre-operative planning based on previously acquired imaging that is used for targeting particular structures. Because there is no official guideline regarding O-Arm from CMS; different payers have different policies regarding this procedure. Also consider reporting the fluoroscopy options, 76000 (Fluoroscopy [separate procedure], up to 1 hour physician or other qualified health care professional time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]), 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]), 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural or subarachnoid]), or 72291 (Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation [sacroplasty], including cavity creation, per vertebral body or sacrum; under fluoroscopic guidance).