Advanced Search

Neurosurgery Coding Alert

Reader Question:

Include Simple Dural Repair

Published on Tue Feb 10, 2004

Question: If the surgeon performs a laminectomy and must repair a dural tear at the same level, may we report a separate code, or is the repair part of the surgical global package? My payer has been denying these claims.

Oregon Subscriber

Answer: Generally, a surgeon may not bill additional codes for routine complications during surgery. In this case, the payer will consider repair of a small dural tear a part of the surgery package.

But if the surgeon must perform significant repair, such as that requiring additional bone removal for exposure and/or graft application, you have two coding choices:

 

  • You may append modifier -22 (Unusual procedural services) to the appropriate laminectomy code to report the unusual effort involved or,
     
  • If the surgeon feels that the repair was truly significant and much greater than routine, report 63707 (Repair of dural/cerebrospinal fluid leak, not requiring laminectomy) along with the laminectomy code (if an additional level of laminectomy is required, use 63709, Repair of dural/cerebrospinal fluid leak or pseudo-meningocele, with laminectomy).

    For those payers that require it, be sure to append modifier -51 (Multiple procedures) to 63707 or 63709.

    • Other Articles in this issue of

    Neurosurgery Coding Alert

    View All