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Removal of a Ventriculoperitoneal Shunt and exchange of EVD drain

Deborah h Posted Mon 13th of April, 2015 12:06:06 PM

I know that the cpt code is 62256 for the removal of the VP shunt; however, my question is, Can you charge for the exchange, removal, or insertion of the EVD drain;note the drain isn't used to record pressure, but for drainage only; can you charge; and what cpt code(s) would be used? Also, I know in other questions concerning this; cpt code 61107 (twist drill) and 61210 (burrhole) was given; however, this evd was place through the same opening and was used for drainage not monitoring;pressure recording. Please let me know what would be coded for the exchange of the EVD. Please give references of your findings.

SuperCoder Answered Tue 14th of April, 2015 05:34:58 AM

Their is no such code for exchange of EVD from the same incision. The suggested codes here can be CPT 61107 (twist drill) and 61154 (burr hole). Both codes should be reported with -52 modifier. Use the code from above 2 codes to document that EVD was exchanged through the prior burr hole or twist drill incision.
Example: 61107-52 for EVD exchange from prior twist drill incision.
61154-52 for EVD exchange from prior burr hole incision.

Deborah h Posted Tue 14th of April, 2015 08:39:27 AM

Would you still report 61107 if the EVD is for drainage only and not for pressure recording or monitoring device?

SuperCoder Answered Wed 15th of April, 2015 00:39:15 AM

No, for EVD drainage only, please use CPT 61105 (Twist drill hole for subdural or ventricular puncture).

Deborah h Posted Wed 15th of April, 2015 23:28:02 PM

I thought that you can't charge separately for an EVD if a procedure was done and the drain was placed through the same burr hole. Example if a craniectomy was done and an EVD was placed; I thought that you can't charge if the physician uses the same burr hole that was used for the craniectomy. Is this the same case in the scenario I listed above, or you saying you can charge for the drains when the shunt is removed and the EVD are exchanged? Please list your sources.

SuperCoder Answered Thu 16th of April, 2015 06:53:11 AM

We are consulting with our expert on this query.

Please be with us.

Thank you for your patience.

Deborah h Posted Thu 16th of April, 2015 10:42:43 AM

Please let me know what your expert says.

SuperCoder Answered Mon 20th of April, 2015 01:51:39 AM

We are still in consultation with our experts on this query.

Please be with us.

Your patience on this is much appreciated.

SuperCoder Answered Mon 20th of April, 2015 01:51:39 AM
We are still in consultation with our experts on this query. Please be with us. Your patience on this is much appreciated.
Deborah h Posted Mon 20th of April, 2015 08:21:56 AM

ok, please let me know when you get the answer.

Deborah h Posted Sun 03rd of May, 2015 08:59:00 AM

Please let me know when you get this answer.

SuperCoder Answered Tue 12th of May, 2015 06:16:00 AM

We could not get any further clarifications/updates from our consulting editor for the above. Our CE is out of office too. We request you to get in touch with your payer to know better specifics about billing of such scenario. In the mean time, if we can get some update, we will communicate with you. Thank you.

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