Wiki Neurosurgeon created dural tear during procedure, thinks he can charge for it!

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marci_ann

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Hello....if a doctor creates a dural tear during a Neurosurgery procedure (looks like he created the tear when he removed a synovial cyst), he cannot charge for that, correct? Do any of you know of any articles that explain this scenario? Doctor doesn't understand why he can't charge for it. Sigh.
 
It's hard to advise on this without seeing the medical record. Are you able to provide any additional detail about what is documented? And what is the procedure that he is wanting to charge for?
 
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If the surgeon creates the tear. then its considered incidental to the procedure. This is just like repairing an annular tear, its incidental to the procedure you are performing. If you created it, you cant charge extra for closing it. The only time you can consider and extra code is if, for example, a tumor invaded the space you are working in, and grew through the dura and it required a dura graft. In that case, the tumor created the defect in the dura. Otherwise its counted as part of your closure.
 
Additional question

sarab86 said:
If the surgeon creates the tear. then its considered incidental to the procedure. This is just like repairing an annular tear, its incidental to the procedure you are performing. If you created it, you cant charge extra for closing it. The only time you can consider and extra code is if, for example, a tumor invaded the space you are working in, and grew through the dura and it required a dura graft. In that case, the tumor created the defect in the dura. Otherwise its counted as part of your closure.
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If the Ortho performed the annular tear and he called the Neurosurgeon to repair it, is it billable by the Neurosurgeon?
 
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