You Be the Coder:
Replacement of Skull Flap
Published on Fri Sep 01, 2000
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: When charging for a craniotomy, what is the correct code for the replacement of the skull flap with titanium plates and screws?Gina Kelly
Hot Springs, Ariz.
Answer: Bill CPT 2000 code 62143 (replacement of bone flap or prosthetic plate of skull), recommends Rhonda Petruziello, CPC, reimbursement specialist for neurosurgery at Cleveland Clinic Foundation in Cleveland. This is a procedure that usually is planned or staged and would require a -58 modifier (staged or related procedure or service by the same physician during the postoperative period) if it is performed within the 90-day global period of the primary procedure. The operative reports for both surgeries should indicate clearly that this was a planned procedure to ensure maximum reimbursement from the carrier. If the -58 modifier is not appended and the surgery is performed within 90 days of the primary surgery, it is likely that the carrier will reduce or even deny this code. Note: If the replacement of the bone flap is at the initial craniotomy, this would be included in the charge for the craniotomy as part of the closure. |
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