Neurosurgery Coding Alert

Answer: Code +61795 (Stereotactic computer assisted volumetric [navigational] procedure, intracranial, extracranial, or spinal [list separately in addition to code for primary procedure]) generally describes the use of an external, three-dimensional frame that provides points of reference (based on the Cartesian coordinate system) to locate a precise brain location(s).

The stealth navigation system is slightly different and uses infrared guidance to create a three-dimensional picture of the patient's head and brain (or spine) and show the exact position of the tools. With the image displayed on a screen, the machine acts as a tracking device, calculating the surgeon's movements during surgery.

Although the technology is different, the stealth system's purpose is sufficiently similar to stereotactic guidance to be reported using the same code, and payers should recognize 61795 for this procedure. In addition, the national Correct Coding Initiative does not bundle 61795 to craniectomy 61510 (Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma). Note, however, that it's possible that the payer, if other than Medicare, uses a different bundling software such as ClaimChek, which includes many edits not in CCI.

Appeal the payer's decision. Be sure to provide documentation to explain the justification for using stealth navigation and explain that the technology is comparable in purpose to stereotactic techniques.