Neurosurgery Coding Alert

Question: Our surgeon performed halo pin replacement. Can we bill for this, or is it considered part of the original procedure since the same physician handled both cases? Missouri Subscriber Answer: The procedure is probably not a billable service, especially since the same physician performed the  initial insertion and replacement. The original procedure also includes the subsequent removal of the halo device. Most payers won't cover the pin replacement unless it was due to a new injury or something to that effect. Example: Pin replacement is occasionally done for reasons such as infection and loosening. If your physician provides a significant service during the global period outside of the usual postoperative care (such as inspection of pin sites, checking that connections are tight) to manage the cause of the pin problem, you might consider billing an E/M service.