Neurosurgery Coding Alert

Neurosurgeons use a variety of modalities to perform stereotactic radiosurgery, depending on the equipment available. Although codes 61796- +61799 apply to any of the techniques, knowing the differences helps you better understand the procedures. Deborah Messinger, CPC, a coding specialist with Massachusetts General Physicians Organization in Charlestown, says radiosurgery can be performed with any type of beam of ionizing radiation:

• Gamma ray radiosurgery is Cobalt-60 based radiation (Gamma Knife)

• Linear accelerator based radiation is X-ray radiosurgery (Linac, CyberKnife, Novalis TX, Tomo Therapy)

• Proton beam radiosurgery uses proton particle beams from a cyclotron.

Your surgeon's approach can also hinge on the case complexity. "We generally use Linac for simple treatments that won't take a long time and that don't require as much sophistication in performing the treatment," Messinger says. "Usually this is a patient with one or two small brain metastases."