Neurosurgery Coding Alert

Question: Encounter notes indicate that the surgeon performed cranial halo removal on a child whose skull was thinner than normal. Is there a code for this service, or would you consider it part of another surgical code?

AAPC Forum Participant

Answer: It depends on whether or not your surgeon applied the halo initially. If your surgeon places the cranial halo — and removes it at a later date — it is considered part of the surgical package for the cranial halo application code 20664 (Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)).

If, however, a different surgeon applied the cranial halo and your surgeon removed it, you can report 20665 (Removal of tongs or halo applied by another individual) for the service.