Neurosurgery Coding Alert

Question: If our surgeon does an exploration and decompression of the right brachial plexus, resection of the right cervical rib, and intraoperative stimulation of the brachial plexus, how should we report these services.Alaska SubscriberAnswer: You would report 21615 (Excision of first and/or cervical rib) or 21705 (Division of scalenus anticus with resection of cervical rib) for the rib resection. If the procedure additionally entailed neuroplasty of the brachial plexus, you could alternatively report 64713 (Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus) as the primary procedure and one of the rib resection codes modified by 51 (Multiple Procedures:....). The intraoperative stimulation of the brachial plexus would not be separately reportable by the operating surgeon.