Neurosurgery Coding Alert

Question: If our surgeon uses a neuroendoscope, for instance for dissection of adhesions (62161), may we code separately for using a twist drill to gain access? California Subscriber Answer: No, you may not code separately for access with neuroendoscopy. The national Correct Coding Initiative (CCI) bundles "access" procedures, such as burr hole and twist drill procedures, to the endoscopy. Specifically, every code in CPT's "twist drill, burr hole(s), or trephine" section (61105-61253) is an included component of intracranial neuroendoscopy codes 62161 (Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intra-ventricular cysts [including placement, replacement or removal of ventricular catheter]) and 62162-62165. This means that you should not separately report using the twist drill, cranial burr or trephine when the surgeon uses any of these devices to allow for the neuroendoscope's entry into the skull.