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Question: The neurosurgeon created a ventriculo-peritoneal shunt to drain a buildup of cerebrospinal fluid (CSF) in a patient with obstructive hydrocephalus. They placed a catheter in one of the patient’s brain ventricles in order to drain a buildup of CSF, redirecting it to the peritoneal cavity to be absorbed by the patient’s body. In order to confirm shunt placement, the surgeon also used neuroendoscopy during the surgery. How should I code this encounter?

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Answer: You’ll be able to report procedure codes for the shunt surgery and the neuroendoscopy, as correct shunt placement necessitated the guidance. On the claim, you should report:

• 62223 (Creation of shunt; ventriculo-peritoneal, -pleural, other terminus) for the shunt surgery
• +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)) for the neuroendoscopy
• G91.1 (Obstructive hydrocephalus) appended to 62223 and +62160 to represent the patient’s hydrocephalus

In addition to confirming shunt placement, there are other reasons that the surgeon might opt for a neuroendoscopy during shunt creation: for example, ventricle evaluation, associated condition treatment, or management of complications.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC