Neurosurgery Coding Alert

Warning: A modifier shouldnt be a shoo-in when surgeon converts to an open procedure.

If youre scrambling to find a code to describe when your neurosurgeon uses an endoscope during a lumbar discectomy, you could be making your task harder than it should be. Take this five-question challenge and avoid these claim calamities.

Figure Out These 5 Questions

Question 1: The neurosurgeon performs fenestration of an intracranial cyst employing an open approach using craniectomy. How should you report this?

Question 2: The neurosurgeon performs fenestration of an intracranial colloid cyst using the neuroendoscope.How should you report this?

Question 3: The surgeon attempts to remove a pituitary tumor via the endoscope (62165, Neuroendoscopy,intracranial; with excision of pituitary tumor,transnasal or transsphenoidal approach). During the initial approach, however, the surgeon encounters unexpected anatomical features that make using the endoscope too risky. The surgeon removes the endoscope and instead opts to remove the tumor via incisional transeptal approach. How should you report this?

Question 4: Your surgeon uses an endoscope to assist during lumbar laminotomy for discectomy. What should you report?

Question 5: Can you separately report use of the twist drill, cranial burr, or trephine when the surgeon uses any of these devices to allow for entry of the neuroendoscopeinto the skull?

Have your answers? Turn to page 28 to compare yours with our experts.