Neurosurgery Coding Alert

Question: Is it appropriate to report 61107 or 61210 for placement of a ventricular drain for intraoperative ventricular decompression with a craniotomy?

Tennessee Subscriber

 
Answer: If the ventriculostomy is placed via the craniotomy incision or the same burr hole, it is included in the craniotomy (e.g., 61304-61545) and may not be reported separately. But if a separate twist drill hole or burr hole is needed for placement of the ventriculostomy, 61107 (twist drill hole for subdural or ventricular puncture; for implanting ventricular catheter or pressure recording device) or 61210 (burr hole[s]; for implanting ventricular catheter, reservoir, EEG electrode[s] or pressure recording device [separate procedure]), as appropriate, may be separately reported. Some payers require that modifier -59 (distinct procedural service) be appended to 61107 or 61210 to indicate that the ventriculostomy was a distinctly separate procedure.