Neurosurgery Coding Alert

Fossa, dura, and approach will steer you to the right code.Accessing lesions in the intracranial area can be quite complex, particularly if your neurosurgeon uses a skull base approach -- which can involve multiple skull base structures. If you follow three steps below, you'll be well on your way to accurately coding these procedures.1. Confirm the Fossa SiteThe first step in reporting skull base surgeries is to confirm in the operative note the lesion location. "A fossa is a hollow or depressed area. The skull is divided into anterior, middle, and posterior fossae," explains Jennifer Schmutz, CPC, health information coder at the Neurosurgical Associates, LLC in Salt Lake City, Utah. Look for terms in the note such as 'craniofacial' or 'orbitocranial' approach and terms referring to the bones of the face like ethmoid, sphenoid, maxilla, and others to help confirm that the approach is through the anterior cranial fossa. Also, note [...]