Neurosurgery Coding Alert

Question: Our surgeon performed a skull-based procedure to access an aneurysm, then performed a clip ligation of the aneurysm. Are we allowed to code for both procedures?

Luoisiana Subscriber

Answer: Yes, you can code both procedures if your surgeon's documentation supports them.

Example: You might report 61583 (Craniofacial approach to anterior cranial fossa, intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa) for the access and 61601 (Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft) for the clip obliteration.

Exception: However, if your neurosurgeon did not use a skull base approach that requires osteotomy, the craniotomy for aneurysm codes (61697-61698, Surgery of complex intracranial aneurysm, intracranial approach...; or 61700-61702, Surgery of simple intracranial aneurysm, intracranial approach ...) would apply instead. 

-- Technical and coding guidance for You Be the Coder and Reader Questions provided by Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison.