Neurosurgery Coding Alert

Question: A neurosurgeon who is new to our practice is using the endoscope (i.e., endoscopic fenestration ventricles, and other procedures). Can you tell me how to code?

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Answer: Rhonda Petruziello, CPC, reimbursement specialist for neurosurgery at Cleveland Clinic Foundation in Cleveland, says that CPT 2000 does not have a particular code to describe the use of an endoscope for neurosurgical procedures. However, the use of the endoscope does add value to the procedure and should therefor be identified for appropriate reimbursement.

Petruziello recommends appending the -22 modifier (unusual procedural services) to the appropriate CPT code. For example, when a neurosurgeon performs a third ventriculocisternostomy (62200), he or she very often will do so using the endoscope. The correct coding would be 62200-22.

The neurosurgeon will need to provide the operative record for these cases and this should lead to an increase in reimbursement.