Neurosurgery Coding Alert

Question: How should i code the removal of a subcutaneous reservoir? The placement code is 61215.

Virginia Subscriber

Answer: There is no specific code for removal. Often, insertion codes will implicitly include the removal of whatever was inserted. But, its difficult to say that the removal of subcutaneous reservoir is included in 61215 (insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter), because Medicare bundles it into 61210 (burr holes[s]; for implanting ventricular catheter, reservoir, EEG electrode[s] or pressure recording device [separate procedure]). For this reason, 61215 is not usually used.

Your best bet is to use 64999 (unlisted procedure, nervous system) and include a copy of the operative report with the claim. If you wish to petition the AMA/CPT editorial board for a specific removal code, send a letter explaining that gaining reimbursement for this service is often difficult and include a redacted copy of the operative report.

Note: Such queries can be mailed to: CPT Editorial Research and Development, American Medical Association, 515 North State Street, Chicago, IL. 60610.