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Neurosurgery Coding Alert

Reader Question:

Look to Unlisted-Procedure Code for EDAS

Published on Tue Feb 10, 2004

Question: What is the proper code for encephaloduroarteriosynangiosis with a diagnosis of left internal carotid occlusion with vascular insufficiency?

South Carolina Subscriber Answer: Encephaloduroarteriosynangiosis (EDAS) describes a procedure in which the surgeon dissects a scalp artery over a course of several inches prior to making a small temporary opening in the skull directly beneath the artery. The surgeon then sutures the artery to the surface of the brain and replaces the bone.

Perhaps the closest CPT code to describe this procedure is 61711 (Anastomosis, arterial, extracranial-intracranial [e.g., middle cerebral/cortical] arteries), but EDAS does not include anastomosis. Therefore, you should choose unlisted neurological procedure code 64999 (Unlisted procedure, nervous system) for EDAS. Be sure to include a full operative report describing the procedure so that the insurer can make an informed payment decision.

Most insurers do not have a written policy regarding EDAS or when it is covered, so you may wish to obtain precertification for the procedure.

Note: For complete information on reporting unlisted- procedure codes, see Neurosurgery Coding Alert, February 2004.
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