Neurosurgery Coding Alert

Question: In a patient with resistant epilepsy, our surgeon did a craniotomy and excised an epileptogenic focus. How can we report these services?

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Answer: When your surgeon does a craniotomy to excise an epileptogenic focus, you can choose from the following codes depending upon whether an electrocorticography was performed:

• 61534 (Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery) when an EEG is not obtained, and
• 61536 (Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery [includes removal of electrode array]) when an EEG is obtained.

Look for more details in the operative note. You have a number of other codes you may report for excision of an epileptogenic brain region that are more specific depending on the location of the epileptogenic focus.