Neurosurgery Coding Alert

Question: Encounter notes indicate the provider replaced a distal catheter in a cerebrospinal fluid shunt system. During the procedure, they also placed a neuroendoscopic ventricular catheter. Should I report 62230 for this service? It doesn’t seem to cover the cath placement.

Florida Subscriber

Answer: Yes, you should report 62230 (Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system) along with +62160 [Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure)].

Your coding was slightly off, perhaps because you missed the parenthetical guidance below the code descriptor.

Beneath the code descriptor for 62320, CPT^® offers this guidance: “For intracranial neuroendoscopic ventricular catheter placement, use +62160 [Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure)].”

Also, the 62230 entry has this guidance: “For replacement of only the valve and proximal catheter, use 62230 in conjunction with 62225 [Replacement or irrigation, ventricular catheter].)