Reader Question:
Choose 61210 for Frontal Ventriculostomy
Published on Thu Sep 11, 2003
Question: What is the correct code for right frontal ventriculostomy? The operative report states that the surgeon drilled a single trephine, tapped the right frontal horn and inserted a Becker ventricular catheter.
Virginia Subscriber Answer: In this case, report 61210* (Burr hole[s]; for implanting ventricular catheter, reservoir, EEG electrode[s] or pressure recording device [separate procedure]). Although this code does not specifically mention trephination, several codes in this section (for instance, 61140-61151, Burr hole[s] or trephine ...; and 61250, Burr hole[s] or trephine, supratentorial, exploratory, not followed by other surgery, and others) bundle burr holes and trephination, which are similar in size and degree of difficulty.
The only other code choice, 61107* (Twist drill hole for subdural or ventricular puncture; for implanting ventricular catheter or pressure recording device), specifies "twist drill hole" only. A twist drill hole differs more significantly from trephination than does a burr hole. For instance, nowhere in this section does CPT bundle twist drill hole and trephine as it does burr hole and trephine. Therefore, 61107 is not the best choice.
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