Neurosurgery Coding Alert
Report Shunt Conversion as New Shunt
Question: How do we report when our surgeon converts a subdural peritoneal shunt to a VP shunt? Our surgeon removed the rickham reservoir for the subdural peritoneal shunt and took out the catheter. Then he created a new craniotomy and put in a new ventricular catheter and attached to the rickham reservoir. How can we report these steps? Which is a better code: 62194 or 62258?
Codify Subscriber
Answer: You are describing removal of a subdural catheter and replacement with a ventricular catheter attached to the previous distal drainage system. There is no clear-cut CPT® code to describe this scenario. The most accurate option for the scenario described would be to submit CPT® code 62225 (Replacement or irrigation, ventricular catheter). You could report code 62194 (Replacement or irrigation, subarachnoid/subdural catheter) as this code is also for replacement of a catheter, but 62225 better reflects the final placement of a ventricular catheter.
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