dlashua
Networker
Surgeon and I do not agree on which CPT code is appropriate........
Patient was then co-registered w/his preoperative MRI using the brain lab image guidance system as we would use this to plan the approach to the tumor. This frontal high anterior enhancing region of the tumor was identified using the brain lab and that corresponded to an area superior to and well in front of the main mass as I wanted to avoid the patient?s motor strip. I then planned a coronally oriented roughly 2 ? 2.5 inch incision over that area. This area was marked, prepped and draped.
We incised the skin down to the calvarium. I then made a posterior bur hole and turned roughly 3-4 cm circumferential flap bringing that anteriorly. This was stripped off the dura. Tack stitches were placed. The dura was opened in a cruciate fashion over the brain. I then used the brain lab wand to confirm that I was in the right area. I made a generous surrounding corticotomy. I removed a piece of the superficial cortex that corresponded to the enhancing portion of the tumor and then took multiple deep biopsy specimens in the region of the enhancing tumor. This was sent for frozen section initially and then subsequently in multiple pieces for permanent pathological examination.
Dura was closed; bone flap was positioned and put in place with titanium plates and self-tapping screws.
So I was hoping that someone would respond without me putting the CPT codes that we are considering, but it hasn't happened.
The Surgeon is requesting CPT 61510
I think a more appropriate code is 61140 w/ 61781 or perhaps 61750
Thoughts?
Patient was then co-registered w/his preoperative MRI using the brain lab image guidance system as we would use this to plan the approach to the tumor. This frontal high anterior enhancing region of the tumor was identified using the brain lab and that corresponded to an area superior to and well in front of the main mass as I wanted to avoid the patient?s motor strip. I then planned a coronally oriented roughly 2 ? 2.5 inch incision over that area. This area was marked, prepped and draped.
We incised the skin down to the calvarium. I then made a posterior bur hole and turned roughly 3-4 cm circumferential flap bringing that anteriorly. This was stripped off the dura. Tack stitches were placed. The dura was opened in a cruciate fashion over the brain. I then used the brain lab wand to confirm that I was in the right area. I made a generous surrounding corticotomy. I removed a piece of the superficial cortex that corresponded to the enhancing portion of the tumor and then took multiple deep biopsy specimens in the region of the enhancing tumor. This was sent for frozen section initially and then subsequently in multiple pieces for permanent pathological examination.
Dura was closed; bone flap was positioned and put in place with titanium plates and self-tapping screws.
So I was hoping that someone would respond without me putting the CPT codes that we are considering, but it hasn't happened.
The Surgeon is requesting CPT 61510
I think a more appropriate code is 61140 w/ 61781 or perhaps 61750
Thoughts?
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