Neurosurgery Coding Alert

Question How do we report when two surgeons in the same practice worked for the surgery? The procedure title was as under: "Right temporal and inferior temporal craniotomy, removal of skull base tumor and tumor of parasellar region with intercavernous exploration. Right orbital craniectomy and removal of intraorbital tumor. Anterior and middle fossa reconstruction with pedicle flap."California SubscriberAnswer: Coding of skull base procedures can certainly be challenging. The detailed operative description is often critical in choosing the correct coding combination. Your brief description includes an anterior fossa approach for excision of what appears to be an extradural tumor and a middle fossa approach for excision of a parasellar and intracavernous tumor, presumably extradural as well. While choice of skull base approach and definitive procedure codes should be considered, the brief description provided does not delineate the type of bony excision required in skull base surgery procedures. One should use the [...]