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Neurosurgery Coding Alert

Reader Questions:

Include Halo Adjustment in Global

Published on Sat Sep 11, 2004

Question: Is there a code for adjusting a cervical halo without anesthesia?

Illinois Subscriber Answer: If the surgeon made the adjustment during the post-op period, you shouldn't bill, because periodic adjustments in the office are a component of halo care.
 
Depending on how the surgeon accomplished the original procedure, you probably reported either 20661 (Application of halo, including removal; cranial) or 20664 (Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology [e.g., pediatric patients, hydrocephalus, osteogenesis imperfecta], requiring general anesthesia). Each procedure carries a 90-day global period.
 
After the global period ends, you should factor halo adjustments into your E/M visits (99211-99215 for established outpatients).
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