Neurosurgery Coding Alert

For the first time, CPT officially recognizes neuro-endoscopic procedures with seven codes (six all-new codes and one code revision) that will allow coders to more precisely report these services:

+ 62160 Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (list separately in addition to code for primary procedure)

Note: This add-on code must accompany 61107, 61210, 62220, 62223, 62225 or 62230

62161 Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement or removal of ventricular catheter)

62162 with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage 62163 with retrieval of foreign body 62164 with excision of brain tumor, including placement of external ventricular catheter for drainage

62165 with excision of pituitary tumor, transnasal or transsphenoidal approach

62201 (revised) Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method. Neuroendoscopy is a relatively new, minimally invasive technique that uses a thin endoscope (about 5 mm in diameter) to approach deep structures of the brain. As noted in AMA's CPT Changes 2003: An Insider's View, neuro-endoscopy "allows the performance of certain neurosurgical procedures with less invasiveness and trauma to the skull, brain and meninges." The addition of neuroendoscopic codes to CPT signals a growing acceptance of the method in neurosurgical practice, although endoscopic procedures are common and well established for other surgical specialties (for example, orthopedic surgery). Note that surgical endoscopy always includes diagnostic endoscopy. Look to future editions of Neurosurgery Coding Alert for a full review of the new codes.