Neurosurgery Coding Alert

Question: Is 61795 for intraoperative navigation, or for planning prior to surgery?


Kansas Subscriber


Answer: Code +61795 (Stereotactic computer assisted volumetric [navigational]
procedure, intracranial, extracranial, or spinal [list separately in addition to code for primary procedure]) describes services performed prior to surgery.

Planning involved in 61795 may take about "one to two hours and includes determination of the coordinates for the target, measurement of the AC-PC line, and angle calculation," according to the AMA's CPT Assistant, November 1999.

Specifically, the surgeon uses a computer to determine various trajectories to assist in calculating the exact point of incision and entry before taking the patient into the operating suite. In effect, the surgeon creates a virtual image of the anatomy and surgical target on a computer to determine the best approach.

Because 61795 is an add-on code, you must claim it in addition to a primary procedure, which could include many spinal or cranial surgeries (for instance, 61312, Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural or 63270, Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical). The surgeon should be sure to document her planning activities prior to surgery in the operative note.

Be aware, however, that the National Correct Coding Initiative does bundle 61795 to a number of codes, including all procedures with "stereotactic" in the descriptor (for example, 61793, Stereotactic radiosurgery [particle beam, gamma ray or linear accelerator], one or more sessions) and application of cranial tongs or halo as described by 20660 and 20661. Check the NCCI prior to reporting 61795 to be sure you're not violating bundling guidelines.