Neurosurgery Coding Alert

Reader Questions:

Post-Op Care Includes Halo Adjustments

Question: How can we code for adjusting a cervical halo without using anesthesia?

Indiana Subscriber

Answer: You can't report halo adjustments separately.

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 has a 90-day global period. Periodic adjustments in the office are a component of halo care and are included in the global period.

When the global period ends, you should factor halo adjustments when deciding on an appropriate E/M level (99211-99215 for established outpatients).

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