Deborah h Posted Mon 16th of February, 2015 18:54:05 PM
If you remove the eternal ventricular drain and replace it with a ventriculoperitoneal shunt will the cpt code be 62258 or 62223 (and your not allowed to charge for the removal). Please give supporting documentation.
SuperCoder Answered Thu 19th of February, 2015 04:39:49 AM
Thank you for your question.
External ventricular drain removal and replacement with ventriculoperitoneal shunt should be coded with following codes.
62225 for replacement of ventricular catheter
62223 for creation of ventriculo-peritoneal shunt
There is no bundling between these codes.
Code 62258 suggested in your query is for replacement of ventriculoperitoneal shunt sytem but in above scenario external ventricular drain has been replaced by a shunt (EVD replaced by VPS).
However, if you are not allowed to bill for the removal of external ventricular drain then you should only code 62223.
Hope it helps answer your query.
Deborah h Posted Thu 19th of February, 2015 08:12:09 AM
So the answer is both cpt codes 62225 and 62223 or just 62223 for external ventricular drain removal and replacement with ventriculoperitioneal shunt.
SuperCoder Answered Thu 19th of February, 2015 08:33:51 AM
In ideal scenario you should code both CPT codes 62225 and 62223 as these codes do not bundle.
However as you mentioned in your question that we are not allowed to bill for the removal, in this particular case you should only issue 62223.
Hope it clarifies.
Deborah h Posted Thu 19th of February, 2015 09:00:14 AM
Sorry, I will have only cpt code 62223 billed for the removal of the external ventricular drain and replacemnt of the ventriculoperitoneal shunt as you suggested, but when would you bill both 62225 and 62223? I thought venticular catheter was included in cpt code 62223.
Deborah h Posted Thu 19th of February, 2015 09:08:07 AM
What is the ideal scenario; I just want to make sure I code this correctly.I was suggesting that you can't bill for the removal; is that correct? and/or can you charge for the replacement 62225 with 62223 the ventriculoperitioneal shunt?
Deborah h Posted Thu 19th of February, 2015 10:02:57 AM
If the evd was removed and a new ventricular catheter passed and the shunt put in; would you charge 62225 and 62223? or is the ventricular catheter included in the shunt and can't be charge for the replacement of the drain? If you can charge for 62225 then you are saying that the drain is a ventricular catheter? Is there a separate charge for the implant of the ventricular catheter?
SuperCoder Answered Tue 24th of February, 2015 07:48:10 AM
Thank you for your followup questions.
As per your last query, If EVD is removed and new ventricular catheter passed and shunt put in then you would code both 62225 and 62223. There is no bundling between these codes per NCCI edits.
62225 is for replacement of ventricular catheter (you are correct ventricular drain and ventricular catheter are doing same function to drain out the CSF)
62223 is for putting in ventriculo-peritoneal shunt system.
On the last part of your question, yes there a separate CPT for implantation of ventricular catheter which is 61107 or 61210 depending upon the type of hole created (twist or burr).
Hope it clarifies.