Neurosurgery Coding Alert
Look to Unlisted-Procedure Code for EDAS
Question: What is the proper code for encephaloduroarteriosynangiosis with a diagnosis of left internal carotid occlusion with vascular insufficiency? Answer: Encephaloduroarteriosynangiosis (EDAS) describes a procedure in which the surgeon dissects a scalp artery over a course of several inches prior to making a small temporary opening in the skull directly beneath the artery. The surgeon then sutures the artery to the surface of the brain and replaces the bone.
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Perhaps the closest CPT code to describe this procedure is 61711 (Anastomosis, arterial, extracranial-intracranial [e.g., middle cerebral/cortical] arteries), but EDAS does not include anastomosis. Therefore, you should choose unlisted neurological procedure code 64999 (Unlisted procedure, nervous system) for EDAS. Be sure to include a full operative report describing the procedure so that the insurer can make an informed payment decision.
Most insurers do not have a written policy regarding EDAS or when it is covered, so you may wish to obtain precertification for the procedure.
Note: For complete information on reporting unlisted- procedure codes, see Neurosurgery Coding Alert, February 2004.
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