Neurosurgery Coding Alert

Question: Is +61795 for intraoperative navigation or for planning prior to surgery?

Kansas Subscriber

Answer: Code +61795 (Stereotactic computer assisted volumetric [navigational] procedure, intracranial,extracranial, or spinal [List separately in addition to code for primary procedure]) describes services performed prior to surgery.

Planning involved in +61795 may take about -one to two hours and includes determination of the coordinates for the target, measurement of the AC-PC line, and angle calculation,- according to the AMA's CPT Assistant,November 1999.

What happens: Specifically, the surgeon uses a computer to determine various trajectories to assist in calculating the exact point of incision and entry before taking the patient into the operating suite. In effect, the surgeon creates a virtual image of the anatomy and surgical target on a computer to determine the best approach.

Because +61795 is an add-on code, you must claim it in addition to a primary procedure, which could include many spinal or cranial surgeries (for instance, 61312,Craniectomy or craniotomy for evacuation of hematoma,supratentorial; extradural or subdural or 63270,Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical). The surgeon should be sure to document her planning activities prior to surgery in the operative note.

Warning: The Correct Coding Initiative (CCI) bundles +61795 to a number of codes, including all procedures with -stereotactic- in the descriptor and application of cranial tongs or halo as described by 20660 (Application of cranial tongs, caliper or stereotactic frame, including removal [separate procedure]) and 20661 (Application of halo, including removal; cranial).

Tactic: Check CCI prior to reporting +61795 to be sure you-re not violating bundling guidelines.