Neurosurgery Coding Alert

Question: How would you code coil embolization of two aneurysms, one of the left PCOM and one of the left ophthalmic artery? Would it be appropriate to assign 61624 twice?

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Answer: CPT^® code 61624 (Transcatheter permanent occlusion or embolization [e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation], percutaneous, any method; central nervous system [intracranial, spinal cord]) includes all techniques necessary to accomplish the occlusion of the aneurysm. These may include balloon remodeling technique, neuroform stent, and others. This code can be reported more than once for additional aneurysms treated at the same setting. Treatment of a separate site aneurysm would be reported with the same code using the 59 (Distinct procedural service) modifier to designate the separate anatomical site.  Since these occlusion/emolization codes were developed before the more recent trend of bundling percutaneous vascular procedures, the radiological supervision and interpretation for this procedure is still considered separately reportable as 75894.

Note: When your surgeon does percutaneous transcatheter permanent occlusion or embolization and performs transcatheter intravascular stent placement at the same anatomic location during the same encounter, you should only report the occlusion or embolization. Adding the stent placement code to your claim will just lead to a denial.