Deborah h Posted Wed 25th of March, 2015 11:06:32 AM
How would you code a right frontal percutaneous ventricular tap?
SuperCoder Answered Thu 26th of March, 2015 09:52:08 AM
CPT 61120 seems appropriate.
Deborah h Posted Fri 27th of March, 2015 13:46:31 PM
I show that it was administered through the left lateral recess of the fontanelle towards the left lateral ventricle; wouldn't this be 61000? Also, if three where done in the same surgery; would you code 61000, 61001x2?
SuperCoder Answered Mon 30th of March, 2015 09:32:47 AM
Ok, it was not mentioned in the first question that the tap was done through the fontanelle. I would agree now that the code will be 61000, 61001x2.
Deborah h Posted Tue 31st of March, 2015 07:16:18 AM
If cpt code 61000 is bilateral or unilateral would you still bill multiple?
SuperCoder Answered Wed 01st of April, 2015 02:59:53 AM
If multiple taps are given, then code should be for multiple taps irrespective to the side (unilateral or bilateral).
Deborah h Posted Wed 01st of April, 2015 13:56:30 PM
Sorry, so you are saying if 3 taps are done; regardless of unilateral or bilateral you are to code 61000. 61001x2; two of the taps were unsuccessful? And if one was done on left and one on right then only one tap which is bilateral should be coded, correct? If done in the same session; surgery, multiple taps would be charged?
Deborah h Posted Wed 01st of April, 2015 14:17:17 PM
Please attach supporting links or documentations to indicate that more than one tap (61000 and 61001x2) can be charged in the same surgery, even if 2 were unsuccessful and even if the code is considered bilateral.
SuperCoder Answered Thu 02nd of April, 2015 10:53:48 AM
If I understand the complete picture correctly, you mean the physician did 3 taps, 2 taps were unsuccessful (I assumed that they were successful). The basic premise is count number of successful taps on one side (right/left) and bill CPT 61000 and 61001 accordingly (the reason is sometimes some patients require multiple tapping to drain the pathology), however in case a physician does 2 taps one on each side (bilaterally), then bill only 1 unit of the CPT. As your 2 initial taps were unsuccessful, I feel that you can only bill one unit of CPT 61000.
Deborah h Posted Fri 10th of April, 2015 17:04:57 PM
I'm sorry, this isn't for an infant; if it's for a child over 1 yr old; what code would you use?
SuperCoder Answered Mon 13th of April, 2015 05:20:53 AM
The code assignment for a child over 1 year will remain the same if it is done through the anterior fontanelle as infancy is a period that begins abruptly at birth and last about 18 months and anterior fontanelle usually closes 7-19 months. Code assignment will change only in case it is NOT done through anterior fontanelle.
Deborah h Posted Mon 13th of April, 2015 07:22:15 AM
If the child is older than 19 months; would you use 64999 unlisted code; or is there another code for this procedure?
SuperCoder Answered Tue 14th of April, 2015 08:29:35 AM
The code assignment will depend upon how the tap is done. Most likely it will be done through a twist drill hole, use CPT 61105 for it. In case it is done through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir use CPT 61020. CPT 64999 may be used if there is no code available representing the procedure being done.
Deborah h Posted Wed 15th of April, 2015 09:46:09 AM
Sorry, it was done with a needle in the frontanelle of a child over 19 months old; not with a burr hole or twist drill; that is why I'm saying 64999. Is that correct.
SuperCoder Answered Thu 16th of April, 2015 05:13:54 AM
If it is done through the fontanelle, then use CPT 61000. The age is not the strict criteria till the time it is fontanelle. Because after fusion of fontanelle it becomes a suture, for which there is a more appropriate code available.
Deborah h Posted Mon 20th of April, 2015 07:24:21 AM
What is the more appropriate code when it becomes a suture? I'm not allowed to use 61000 bcs of age restriction and the insurance will deny for age.
SuperCoder Answered Tue 21st of April, 2015 03:00:24 AM
As this is not related to your original query. It is suggested to post this question in new thread.