Neurosurgery Coding Alert

You Be the Coder:

Refrain from Modifier 63 with Meningocele Repair

Question: How  can  we  report  the  repair  of  a  meningocele  that  our  surgeon  did?  Do  we  have  specific  codes  for  meningocele  repair?

Georgia Subscriber

Answer: For the repair of a meningocele, you have discrete codes. Before you head on to finding the right code, check the procedure note to find out the size of the meningocele.

Depending upon the size of the meningocele repaired, you will choose form code 63700 (Repair of meningocele; less than 5 cm diameter) and 63702 (Repair of meningocele; larger than 5 cm diameter).

What is a meningocele? Meningocele is a birth defect in which the meninges, the membranous coverings of the brain and spinal cord, protrude through a defect in the skull or spinal column. This protrusion forms a sac filled with cerebrospinal fluid. If nervous system tissue is also included in the defect, then it is termed a myelomeningocoele.

Note: Codes 63700 and 63702 are exempt from modifier 63 (Procedure  performed  on  infants  less  than  4  kg).