Neurosurgery Coding Alert

Question: The skin over a patient's VP shunt stretched quite thin, so the surgeon opened the area, performed debridement and undermining, and created a new flap. He closed the area and planned to have a plastic consult with the patient the next day. What code applies?

Maryland Subscriber

Answer: The surgeon did not revise or replace the ventriculoperitoneal (VP) shunt, so the correct choice is 14020 (Adjacent tissue transfer or rearrangement, scalp, arms, and/or legs; defect 10 sq cm or less).

Different approach: Your coding would change if your surgeon completed a revision or replacement. In that case, you would report 62230 (Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system).