Neurosurgery Coding Alert

Question: How can I code for placement of Gliadel Wafers? Is there a dedicated code for this, or must I use an unlisted procedure code?

Ohio Subscriber

Answer: You should call on +61517 (Implantation of brain intracavitary chemotherapy agent [List separately in addition to code for primary procedure]).

CPT added +61517 in 2003 to describe placement of the dime-sized disks following excision of a brain tumor.The surgeon implants as many as eight wafers at the site of the excision, where they dissolve over a period of two to three weeks and deliver the chemotherapeutic drug carmustine (BCNU) in high concentrations.

Code +61517 is an add-on code describing implantation of the chemotherapy agent only, and you must report it in addition to either 61510 (Craniectomy, trephination,bone flap craniotomy; for excision of brain tumor,supratentorial, except meningioma) or 61518 (Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull) to describe the primary surgical procedure (that is, the tumor excision).