Neurosurgery Coding Alert

Question: After a computed tomography (CT) scan with contrast materials and 3D rendering, the surgeon applied a halo for thin skull osteology for a patient. The surgeon used a total of nine pins to secure the halo. How should I code this encounter? Also, can I code the removal of the halo separately?

Georgia Subscriber

Answer: For the halo application encounter, report:

• 20664 (Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)) for the halo application
• 70460 (Computed tomography, head or brain; with contrast material(s)) for the CT scan
• 76376 (3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation) for the 3D rendering

Halo removal: Since your surgeon applied the halo, you cannot report its removal separately. As the descriptor for 20664 indicates, the code includes halo removal.

If, however, the surgeon removes a halo that another provider applied, you can code separately for it with 20665 (Removal of tongs or halo applied by another individual).