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endoscopic vs. open skull base surgery

  1. #1
    Default endoscopic vs. open skull base surgery
    Medical Coding Books

    Does anyone's physicians do endoscopic (transnasal) skull base approach/resection of tumors? If so do you use code 64999 or 31299? Or do you go ahead and use the skull base codes 61580-61608? My physicians really want to use the open codes but it seems like the Unlisted is more appropriate.

    Also, if you do use an unlisted how much are you being reimbursed? Is it comparable to the open?


  2. Default
    Specifically, what kind of "skull based" tumor, Pituitary? or something else?

    CT ENT

  3. Default
    You absolutely have to use 64999 to report endoscopic skull base surgery (for removal of skull base meningioma, clival chordoma, etc.), other the endoscopic resection of the pituitary which would be 62165. It is not accurate to report open skull base surgery codes for endoscopic procedures. There is a big practice in Pennsylvania, (not the one I work for), which is in the process of voluntarily refunding insurance companies because of this. At last count they were up to over a hundred thousand dollars in refunds not including what they may have to pay back in fines, additional audits, etc.

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