Neurosurgery Coding Alert

Question: The neurosurgeon performed a cranial expansion in a longstanding hydrocephalus that was not controlled by shunts. He removed the sagittal bone over the sagittal sinus and then circumferentially thinned the inner table underneath the frontal and parietal regions. A decompressive subtemporal craniectomy was done and the cranial bones were returned in hinge fashion with resorbable plating system. The pre-op and post-op diagnosis states 'headaches, likely raised intracranial pressure.' Is ICD code 784 appropriate for this situation? Can 61322 (Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy), 61340 (Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)) and 61559 (Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)) be billed together for this procedure?Alabama SubscriberAnswer: The code 61322 is intended for use in acute [...]