Neurosurgery Coding Alert

Question: Does 61795 include planning before surgery or intraoperative navigation?

Texas Subscriber

Answer: Add-on code +61795 (Stereotactic computer-assisted volumetric [navigational] procedure, intracranial, extracranial or spinal [list separately in addition to code for primary procedure]) describes preoperative planning for stereo-tactic surgery. "This planning may take approximately one to two hours and includes determination of the coordinates for the target, measurement of the AC-PC line, and angle calculation," according to CPT Assistant, Vol. 10, Issue 5. The issue further explains, "Using a computer, various trajectories are determined to assist the physician in choosing the specific trajectory and calculating the entry point through the skull."

You must list 61795 in addition to the primary procedure for which the surgeon uses the computer-assisted navigation. But the National Correct Coding Initiative bundles 61795 into many codes, including intracranial stereotactic procedures 61760 (Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring) and 61793 (Stereotactic radiosurgery [particle beam, gamma ray or linear accelerator], one or more sessions). For payers following NCCI guidelines, you should not report 61795 separately with these procedures.

-- Clinical and coding expertise for You Be the Coder and Reader Questions provided by Eric Sandham, CHC, CPC, compliance manager for Central California Faculty Medical Group, a group practice and training facility associated with the University of California at San Francisco in Fresno.