Compliant Coding for Operating Microscope

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  • November 18, 2015
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Compliant Coding for Operating Microscope

CPT® guidelines disallows +69990 Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure) in addition to any procedure that includes microsurgical techniques as part of the code descriptor (e.g., 22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection; single interspace, cervical). These “disallowed” primary codes are listed in a parenthetical note preceding the code and its descriptor in the CPT® Codebook.
Report 69990 only when the surgeon performs a procedure that requires microsurgery or microdissection. Do not claim 69990 if the surgeon uses the microscope only for magnification or illumination.
Note that Centers for Medicare & Medicaid Services (CMS) regulations limit the reporting of 69990 to far fewer instances than CPT®. In many cases Medicare considers the operating microscope to be bundled to the primary procedure, in opposition to AMA guidelines. Your best bet when reporting 69990 to Medicare payers is to check the National Correct Coding Initiative (NCCI) to be sure that use of operating microscope is not bundled to the primary procedure code.

John Verhovshek
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John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering 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.

No Responses to “Compliant Coding for Operating Microscope”

  1. Misty Wojcik says:

    Great share…
    Thanks for this useful information. I was not aware about code descriptor. Now after reading your post it will be easy for me to set microscope at perfect resolution.
    For microscopy visit