Neurosurgery Coding Alert

 Question: What can you tell me about Gliadel Wafers? Is there a code to describe their placement?

Nebraska Subscriber

 Answer: Gliadel Wafers are dime-size disks containing the chemotherapeutic drug carmustine (BCNU). The surgeon places the disk at the site of brain tumor excision. The disks dissolve over a period of two to three weeks and deliver BCNU in high concentrations.

 CPT added code +61517 (Implantation of brain intracavitary chemotherapy agent [list separately in addition to code for primary procedure]) in 2003 to describe placement of Gliadel Wafers. This is an add-on code, and you must report 61517 in addition to the appropriate excision code (for example, 61510, Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma; or 61518, Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull).