Neurosurgery Coding Alert

Question: I was wondering if you could give me any advice on the correct coding for a syrinx-to-subarachnoid shunt by C5-6 laminectomy. I am considering either code 63172 (Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space) or 63740 (Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy).

Answer: You should report 63172 because the drain's distal portion ends in the subarachnoid space. This is a technique that allows local drainage of a cyst within the spinal cord to the subarachnoid space outside the spinal cord. Over time, these may eventually stop functioning. Consequently, some surgeons choose to connect the distal cyst drainage catheter to a longer catheter that drains the fluid into the pleural or peritoneal spaces, in which case you would choose 63740.