Wiki Dural graft w/ craniotomy

[pmoody@biancosurgery.com]

The surgeon performed a craniotomy for decompression of facial nerve (61458) w/ cranioplasty (62140) then he needed to repair the opening of the dura w/ a patch of DuraGen. What CPT code would I use for the dura graft?

 

[blonde01]

I have been looking for an answer to this as well. My surgeon is repairing the dura with Alloderm. In 2011, he was using 15335 but that is now deleted for 2012 and directs you to 15275 and 15277. I am having trouble finding any REAL documentation to support using or not using those codes. If anyone has anything, please share.

 

[penguins11]

We have always been told that repairing the dura and a cranioplasty is included in the procedure. If you open it, you should close it and can not bill for this separately unless it is a very, very unusual situation. In the case of an unusual situation I would not bill for both the craniplasty and repair of the dura I would bill one or the other but again, we only bill these in very rare circumstances such as crani for brain tumor, they can not replace the bone flap and have to total reconstruct the wound and create something so they can close the area.

 

[blonde01]

My surgeons are performing 61600, 61605, and/or 62120 endoscopically through the sinuses, which codes to 64999. When the dura is repaired they are using 15275. Does that sound correct?

 

[degrasty]

I'd be remiss to code a skin graft code for a dural repair. 9 times out of 10 I have to argue my surgeons down that the repair is part of the closure, unless of course, it's a special circumstance.

 

[blonde01]

I'd be remiss to code a skin graft code for a dural repair. 9 times out of 10 I have to argue my surgeons down that the repair is part of the closure, unless of course, it's a special circumstance.

Yes I agree. I've learned since then that the skin graft codes are not billable for a dural repair. It took alot of arguing. LOL