Neurosurgery Coding Alert

CPT 2000 Changes Affect Neurosurgeons

- Published on Sat, Jan 01, 2000
A number of codes that affect neurosurgeons have been added, deleted or changed in CPT 2000. For example, codes for neurostimulator procedures in particular have become more descriptive, which should help to clarify proper billing for vagal nerve stimulators (VNS). Another major change concerns 61795. Previously, this code described an intracranial procedure. Its new expanded definition now encompasses intracranial, extracranial and spinal.

New Wording From CPT 2000

Several code definitions have been altered in CPT 2000 that should interest neurosurgeons.

22630. CPT 2000 defines 22630 as arthrodesis, posterior interbody technique, including laminectomy and/or diskectomy to prepare interspace (other than for decompression), single interspace; lumbar. This is a significant clarification. Until 2000, the CPT definition for 22630 did not include the laminectomy and/or the diskectomy. Consequently, neurosurgeons billed separately for these procedures and faced denials. In the CCI Correct Coding Initiative, however, these procedures were bundled into 22630. The CPT and CCI now agree.

61751. Code 61751 now is defined as stereotactic biopsy, aspiration, or excision, including burr holes(s), for intracranial lesion; with computerized axial tomography and/or magnetic resonance guidance. This code is used for stereotactic brain biopsies and other surgeries performed with neuronavigational equipment. Only CT scans were recognized previously. The addition of magnetic resonance imaging reflects the use of current technology.

61795. CPT 2000 defines 61795 as stereotactic computer assisted volumetric (navigational) procedure, intracranial, extracranial, or spinal (List separately in addition to code for primary procedure). This code has been used strictly for cranial procedures in the past. Now this procedure can be used for observation and location in the extracranial and spinal areas.

61885. Code 61885 is defined as incision and subcutaneous placement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array. With the placement of certain neurostimulator pulse generators or receivers there may be a single electrode array or a multiple array required. This code has been defined more strictly in CPT 2000 to indicate use for a single array only, while 61886 has been added for connection to two or more electrode arrays.

62273. Code 62273 is defined in CPT 2000 as injection, epidural, of blood or clot patch. This injection generally is required in the wake of a spinal tap if there is a cerebral spinal fluid leak and headaches result. This code now may be used for any part of the spine, whereas it previously could be used only if the injection occurred in the lumbar region of the spine.

62280. CPT 2000 designates 62280 for injection/infusion of neurolytic substance (e.g., alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid. This injection generally is given when the [...]

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