Wiki LAP REPLACEMENT/REVISION, CSF SHUNT, OBSTRUCTED VALVE/DISTAL CATHETER IN SHUNT SYSTEM

amanda19791

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Could someone help me with the scenario below?
Patient was taken the operating room for distal shunt revision/replacement but done laparoscopic. Should
I code unlisted lap code (49329) or the shunt revision/replacement (62230)?
 
Per CPT Assistant, December 2011 and December 2012 articles, as I read them, 62230 should be reported for this.

Replacement or Revision of the Valve and/or Distal Catheter
If the proximal catheter is functioning but the valve or distal catheter needs to be revised or replaced, code 62230, Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system, would be reported.
...

Question:
When performing a ventriculo-peritoneal shunt revision, the neurosurgeon is working in conjunction with the general surgeon. The abdominal part of the procedure is performed by the general surgeon with a laparoscopic approach, instead of open. May code 62230, Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system, be reported?

Answer:
Yes, code 62230 with modifier 62 appended could be used by the general surgeon using a laparoscopic technique because the essential portion of the operation is the same and the size of the incision is not really a factor. If the neurosurgeon uses an endoscopic technique, then code 62160 would be reported by the neurosurgeon, and code 62230 by the general surgeon, but with modifier 62 appended.
 
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