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Left ventricular catheter exchanged; left rickham reservoir removed.

Deborah h Posted Wed 21st of October, 2015 23:22:44 PM

How would you code a debridement of left-parito-occipital wound (14mm less than 20 sqcm); culture of left parieto-occupital wound, removal of left parieto-occipital reservoir, and replacement of left ventricular catheter drain? Please list all cpt codes for this scenario.

SuperCoder Answered Fri 23rd of October, 2015 08:04:36 AM

Thanks for your question.

This is a major operative report and its very difficulty to code exactly without operative note. The information that we have is very limited.

We can use CPT code (11000-11047) as per deapth of wound for debridement of left-parieto-occipital wound
87070,87075,87205 for culture of left parieto-occupital wound. Please find below link for wound culture to use appropriate code as per documentation in the operative report.
CPT 62225 for left replacement of left ventricular catheter.
Hope this will help you.

Deborah h Posted Fri 23rd of October, 2015 09:19:31 AM

ok, but can you give me the code that you would use for the removal of the left parieto-occipital reservoir?

SuperCoder Answered Mon 26th of October, 2015 01:27:20 AM

Hi Deborah,

I would suggest using CPT 62365 for this procedure.

Deborah h Posted Mon 26th of October, 2015 07:42:16 AM

That cpt code is used for a pump that was inserted under the skin for intrathecal or epidural infusion of medication; this is a occipital reservoir for drainage not mediation? Please advise.

Deborah h Posted Mon 26th of October, 2015 09:47:26 AM

Also, if you can't charge for the removal of an EVD; can you charge for the removal of the right parieto-occipital reservoir? If so, would you use an unlisted code 64999?

SuperCoder Answered Tue 27th of October, 2015 04:22:38 AM

Hi Deborah,

As per my understanding, we will not code removal of left parieto-occipital reservoir separately. It is included in the replacement of left ventricular catheter.
If operative note state that both were done at different anatomic locations, then code it with unlisted code (64999) because there is no code for removal of reservoir from occipital area for drainage.

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