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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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 402 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

One Response to “Defining “Simple” vs “Complex” Intracranial Aneurysm”

  1. bob bigaouette says:

    can you code both a 61697 and 36224 if done by the same surgeon during the same procedure to verify the clipping was ‘good’? Thank you for your help.

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