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Conversion of subdural peritoneal shunt to VP shunt

Deborah h Posted Fri 12th of June, 2015 00:34:21 AM

When coding a conversion of a subdural peritoneal shunt to a VP shunt;for the subdural peritoneal shunt if the rickham reservoir was removed and the catheter was taken out; then if a new craniotomy was created and a new ventricular catheter was put in and attached to the rickham reservoir; would you code this 62194 or 62258; or use another cpt code(s). Please explain and give references.

SuperCoder Answered Fri 12th of June, 2015 09:56:09 AM

Well, CPT 62258 seems appropriate for the procedure, as in CPT 62194 is for replacement or irrigation, subarachnoid/subdural catheter only but in CPT 62258 there is removal of complete shunt system; with replacement by similar or other shunt at same operation which appropriate for the given scenario.

Deborah h Posted Sun 14th of June, 2015 10:57:37 AM

But only the subdural peritoneal catheter was replaced by the ventricular catheter and the whole shunt wasn't removed and replaced would it still be coded with 62258? Please explain and give references.

Deborah h Posted Sun 14th of June, 2015 11:17:34 AM

Wouldn't it be coded 62225 revision of proximal shunt?

SuperCoder Answered Mon 15th of June, 2015 09:58:07 AM

Well, in initial query it seems that the whole system has been changed because it is mentioned that rickham reservoir was removed and the catheter was taken out, So 62258 is appropriate in that case. And you are right, when only ventricular catheter has been changed then CPT 62225 is appropriate to code.

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