Neurosurgery Coding Alert

Question: I have an op report in which the neurosurgeon specifies that he performed "control of bleeding." Is this something I can report separate from the primary procedure? Georgia Subscriber Answer: Most likely you should report only the primary procedure. When a neurosurgeon performs a major procedure, payers consider control of bleeding to be an included component of the surgery.   If your physician documented that he spent significant time and effort controlling bleeding during a major pro-cedure, you can try to gain additional reimbursement by appending modifier 22 (Increased procedural services) to the appropriate CPT surgical code.   Example: During repair of ruptured intracranial aneurysm, the neurosurgeon must work extensively to prevent excessive blood loss. You should report 61705 (Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery) and append modifier 22. Provide an op report and cover letter explicitly describing the [...]