Neurosurgery Coding Alert

Question: What does the phrase mutually exclusive mean in the CCI updates?

California Subscriber


Answer: Mutually exclusive procedures are those that cannot reasonably be performed during the same operative session. These procedures are designated mutually exclusive based either on the CPT definition or the medical impossibility/improbability that the procedures could be performed at the same session. An example would be when the repair of an organ can be performed by two different methods and it would make sense to use only one or the other. Another example is billing an initial and subsequent service performed at the same time on the same date of service. Such a classification would be a contradiction. For example, 61312 (craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural), which describes a blood clot on the surface of the brain, is mutually exclusive with 61313 (... intracerebral), a blood clot beneath the surface of the brain. You wouldnt remove the blood clot beneath the surface of the brain without removing the one on the surface.


Questions answered by Kathleen Pride, CPC, CCS-P, coding supervisor, Martin Memorial Health Group in Port St. Lucie, Fla.; and Susan Calloway, CPC, CCS-P, an independent coding consultant and educator in North Augusta, S.C.