Neurosurgery Coding Alert

You Be the Coder:

Bone Flap Craniotomy With Chemo Agent

Question: The surgeon performs a supratentorial bone flap craniotomy for excision of a brain tumor. During the surgery, they also implant a brain intracavitary chemotherapy agent. How should I report this encounter?

Tennessee Subscriber

Answer: For this claim, you’ll need a pair of codes. On the claim, report:

  • 61510 (Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma) for the craniectomy
  • +61517 (Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure)) for the chemo agent implant

More about +61517: This is an exclusive add-on code. According to CPT®, only two codes are approved for use with +61517: 61510 and 61518 (Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull). If you see it used with another code, red flags should rise up.