A co-surgery between otolaryngology and neurosurgery.
The initial approach ((endoscope) trans-sphenoidal to pituitary was by otolaryngology. The neurosurgeon takes over the surgery for the pituitary tumor excision but finds out that the tumor/mass is not pituitary tumor. The mass turns out to be a giant sellar aneurysm. So the neurosurgeon decides to stop surgery.
Neurosurgery dictation:
"we could see some blood swirling inside the lesion and the operation was halted. There was strong suspicion now that this could be a giant aneurysm. The micro-Doppler was used to examine the lesion. The echogenicity was consistent with that of arterial flow. At this time, the decision was made to obtain an intraoperative CT angiogram. The CT angiogram was obtained and indeed showed a large sellar aneurysm. The decision was made not to further proceed with any intervention. The sellar floor was repaired with 2 layers of Surgicel, as well as a muslin graft. This was further reinforced with Fibrin sealant. "
How do I code this for the neurosurgery? Physician submits CPT 62165.
Do I do CPT 62165-52-62?
Or 64999-62 (I'm thinking this is better)?
Or is there a better code?
Is micro-Doppler or intraoperative CT angiogram billable?
Thanks in advance..
The initial approach ((endoscope) trans-sphenoidal to pituitary was by otolaryngology. The neurosurgeon takes over the surgery for the pituitary tumor excision but finds out that the tumor/mass is not pituitary tumor. The mass turns out to be a giant sellar aneurysm. So the neurosurgeon decides to stop surgery.
Neurosurgery dictation:
"we could see some blood swirling inside the lesion and the operation was halted. There was strong suspicion now that this could be a giant aneurysm. The micro-Doppler was used to examine the lesion. The echogenicity was consistent with that of arterial flow. At this time, the decision was made to obtain an intraoperative CT angiogram. The CT angiogram was obtained and indeed showed a large sellar aneurysm. The decision was made not to further proceed with any intervention. The sellar floor was repaired with 2 layers of Surgicel, as well as a muslin graft. This was further reinforced with Fibrin sealant. "
How do I code this for the neurosurgery? Physician submits CPT 62165.
Do I do CPT 62165-52-62?
Or 64999-62 (I'm thinking this is better)?
Or is there a better code?
Is micro-Doppler or intraoperative CT angiogram billable?
Thanks in advance..
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