Wiki Burr hole for drainage subdural hematoma

[pjacobs]

My Neurosurgeon went in and did a burr hole for a drainage of subdural hematoma and the code I have for this is 61154. The question is, he inserted a ventricular drain into the subdural space and tunneled out through a seperate stab incision. The drain was sutured and attached to a drainage bag. What I'm questioning is if this piece can be seperately billed.. 61107? I'm being told yes, but just want to have someone elses thoughts on this.

Thanks so much

 

[RebeccaWoodward*]

I tend to think that if the drain was inserted through the same burr hole, it would be inclusive. It would interesting to see if the carrier would consider the "tunneling through a separate stab", a separate procedure since it appears that the drain was inserted through the original burr hole. This is an excerpt from the "Neurosurgery Answer Book"...

In general, when a twist drill procedure is followed by a larger, more extensive procedure at the same operative session involving the same anatomic sites, only the code reflecting the more extensive procedure should be reported. If performed on the same date as a more extensive procedure, but at a different surgical session or involving a different operative site, both codes may be reported. However, a 59 modifier should be attached to the twist drill procedure code.

 

[pjacobs]

Thanks so much.