Defining “Simple” vs “Complex” Intracranial Aneurysm
When coding for treatment of intracranial aneurysm, you must select between codes describing “simple” aneurysm and “complex” aneurysm, as follows:
61697 Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation
61698 Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation
61700 Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation
61702 Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation
How should you make the distinction? The CPT® codebook includes a parenthetical explanation stating:
61697, 61698 involve aneurysms that are larger than 15 mm, with calcification of the aneurysm neck, with incorporation of normal vessels into the aneurysm neck, and/or a procedure requiring temporary vessel occlusion, trapping or cardiopulmonary bypass to successfully treat the aneurysm.
Put another way: The aneurysm qualifies as complex either because of its large size or because of the need for extra effort to clip it or prevent further damage to the blood vessels. If physician documentation is unclear as to the nature of the aneurysm, be sure to ask for clarification. And be aware: Just because an aneurysm is defined as “simple,” doesn’t mean that its treatment is easy.
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