Neurosurgery Coding Alert

Question: Is there a code for adjusting a cervical halo without anesthesia? Illinois Subscriber Answer: If the surgeon made the adjustment during the post-op period, you shouldnt bill, because periodic adjustments in the office are a component of halo care. Depending on how the surgeon accomplished the original procedure, you probably reported either 20661 (Application of halo, including removal; cranial) or 20664 (Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology [e.g., pediatric patients, hydrocephalus, osteogenesis imperfecta], requiring general anesthesia). Each procedure carries a 90-day global period. After the global period ends, you should factor halo adjustments into your E/M visits (99211-99215 for established outpatients).