Neurosurgery Coding Alert

Question: The provider performs an intraoperative ultrasound (US) during the removal of a brain tumor (61510). Can the surgeon bill for both procedures?

Illinois Subscriber

Answer: Despite the fact that no Correct Coding Initiative (CCI) edits exist between 61510 (Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma) and 76998 (Ultrasonic guidance, intraoperative), you should not bill out for 76998. Intraoperative ultrasound guidance is included in a surgical procedure such as 61510. This is consistent with the bundling of imaging modalities like radiography and fluoroscopy needed to perform a larger procedure. Specific exceptions where imaging is reported separately from the procedure are becoming rarer as CPT^® has gradually eliminated separate reporting of procedures that require the use of an imaging modality to accomplish the procedure.