Neurosurgery Coding Alert

Question: Our surgeon performed cyberknife on three different days for multiple intracranial metastases. The insurance is denying as inclusive. Is there an appropriate modifier we should be using?New York SubscriberAnswer: There is insufficient information provided to allow for accurate coding. Even though there were multiple sessions (days), there is a limit of reporting treatment of five lesions altogether. Since metastases are typically simple lesions (although the location may warrant choice of a complex code), the first lesion would be reported with 61796 (Stereotactic radiosurgery [particle beam, gamma ray, or linear accelerator]; 1 simple cranial lesion) and up to four additional lesions would be reported with the add-on code 61797 (Stereotactic radiosurgery [particle beam, gamma ray, or linear accelerator]; each additional cranial lesion, simple [List separately in addition to code for primary procedure]).