Neurosurgery Coding Alert

To submit the right codes, you need clarity on how to distinguish a simplex and complex aneurysm. An intracranial aneurysm is an abnormal dilation or bulge in the blood vessels caused by weakening of the walls of the blood vessel and may rupture to cause a bleed into the surrounding area or may result in pressure symptoms due to compression of surrounding structures. The factors determining the complexity of an aneurysm include the size, calcification, surrounding vasculature, need for vessel occlusion to complete repair. According to CPT^®, an aneurysm is ‘complex’ when:

1. The aneurysm(s) is larger than 15 mm (1.5 cm).

2. The aneurysm involves calcification of the aneurysm neck (the constricted portion at the “base” of the aneurysm).

3. The aneurysm incorporates normal vessels into the aneurysm neck.

4. The aneurysm requires temporary vessel occlusion, trapping or cardio-pulmonary bypass to complete the repair.