Neurosurgery Coding Alert

You shouldn't apply the same "simple versus complex" rules for intracranial arteriovenous (AV) malformations as for intracranial aneurysms. In this case, different circumstances call for different coding tactics.

An AV malformation describes an abnormally fused, tumor-like mass of veins and arteries, which bypasses the arterial capillaries that normally provide nourishment to the surrounding tissue. CPT classifies surgical repair of AV malformations according to location and complexity using codes 61680-61692.

"AV malformations are not he same as aneurysms, and the criteria used to define a complex aneurysm (61697-61698) do not apply to AV malformations," says Eric Sandhusen, CHC, CPC, director of compliance, Columbia University department of surgery.

Rather, you have to rely on the surgeon's documentation - based on his own experience and clinical expertise - to differentiate simple and complex AV malformations, according to the accessibility and difficulty of repair.

Look to future editions of Neurosurgery Coding Alert for more information on this topic.