Neurosurgery Coding Alert

Question: The surgeon made a postauricular incision and dissection down to the turn from the transverse sinus to the sigmoid sinus. He performed a craniotomy and made a dura incision to expose the cerebellopontine angle (CPA) area. He then removed a tumor. How should we code the procedure?

New Hampshire Subscriber

Answer: Your most likely code choice is 61520 (Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor). The exception is if the surgeon also cut through the mastoid antrum (a mastoidectomy). In that case, you would report code 61526 (Craniectomy, bone flap craniotomy, transtemporal [mastoid] for excision of cerebellopontine angle tumor) instead.