Neurosurgery Coding Alert
Report Open Approach for Gelfoam Epidural Repair
Question: Our physician used a piece of gelfoam to block a lumbar dural tear. How can we report this service? Can we submit code 62273 for the dural repair?
Wyoming Subscriber
Answer: You would submit codes for dural repair through an open approach. A surgeon performing an open repair may insert gelfoam or other material over the repair site. Depending upon whether your physician did a laminectomy for the dural repair, you can submit either code 63707 (Repair of dural/cerebrospinal fluid leak, not requiring laminectomy) or 63709 (Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy).
If, however, your physician completes the dural repair during another spinal procedure, it typically is included as part of the surgical procedure and is not separately billable.
You should not report code 62273 (Injection, epidural, of blood or clot patch) for application of a piece of gelfoam to seal an epidural tear. This code is appropriate for injection procedures. To repair an epidural repair, your physician will not perform an injection to insert the gelfoam.
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