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Cyst Fenestration Occipital Craniotomey with a VP shunt externalization

Deborah h Posted Sun 15th of March, 2015 13:47:28 PM

Cpt code 61516 is for a craniectomy for excision of fenestration of cyst; however, what whould you code if it was a craniotomy for cyst fenestration occipital with a vp shunt externalization with stealth?

SuperCoder Answered Mon 16th of March, 2015 03:04:30 AM

CPT code 61516 should be used for bone flap craniotomy for excision of fenestration of cyst.

Externalization of a shunt is considered a "revision," so the appropriate code is 62230 (replacement or revision of CSF shunt, obstructed valve, or distal catheter in shunt system). If the shunt was completely removed and replaced, report 62258 (removal of complete CSF shunt system; with replacement by similar or other shunt at same operation).

Deborah h Posted Mon 16th of March, 2015 08:27:38 AM

What if the shunt was replaced by an EVD drain,how would this be coded?

SuperCoder Answered Tue 17th of March, 2015 02:04:19 AM

You can use CPT code 62258 for replacement of shunt with EVD drain.

Deborah h Posted Tue 17th of March, 2015 07:45:52 AM

I found where I asked this question to Supercoder before and was told that the EVD drain isn't the same as the shunt and since I'm not able to bill for the removal of the external ventricular drain, then I should only code 62223. Please let me know what is correct.

SuperCoder Answered Wed 18th of March, 2015 02:16:19 AM

In the given scenario, you should bill CPT code 61516 along with 62230.

Deborah h Posted Tue 24th of March, 2015 17:12:11 PM

If the ventricular catheter was replace by a Bactiseal catheter, how would you code?

SuperCoder Answered Wed 25th of March, 2015 07:00:20 AM

If there was use of Neuroendoscope then you may use code 62164 for placement of external ventricular catheter for drainage. Otherwise 62223 is correct.
Thanks

Deborah h Posted Wed 25th of March, 2015 07:58:21 AM

I thought that the Bactiseal catheter was an EVD drain; are you saying that it's considered a catheter therefore you would charge 62223 and not 62258? If EVD drain is a a bactiseal catheter, then would you just charge for the removal?

SuperCoder Answered Thu 26th of March, 2015 02:14:31 AM

As you have mentioned above that VP shunt externalization with stealth was performed through Bactiseal EVD catheter, which is considered as a external ventricular drain (externalization) and Externalization of a shunt is considered a "revision". In this case you should use CPT 62230. if Neuroendoscope was used then use code 62164.

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