Neurosurgery Coding Alert

Question: Can we bill intraoperative monitoring if it is read by a different physician than the one who does the surgery? How can we bill for pedicle screw stimulation, implant of subfacial Hemovac, and intradural administration of Duramorph done at the time of surgery?

Ohio Subscriber

Answer: Most intraoperative monitoring cannot be separately reported by the surgeon. Although some intracranial and spinal procedures utilize intraoperative neurophysiology testing such as code 95920 (Intraoperative neurophysiology testing, per hour [List separately in addition to code for primary procedure]), it is only separately reportable by a second surgeon not participating in the surgery, a neurologist, or a physiologist. The pedicle screw stimulation, drain placement, and medication injection are not separately reportable by the surgeon as these are considered bundled with the major procedure(s) performed.