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Denise Posted Wed 07th of March, 2018 18:23:17 PM
Below is a list of the RNS electrode insertions and IPG. I am questioning #4. I know the RNS depth electrodes would be billed with 61863 , but for #4 the craniectomy for strip electrodes I am confused. The only craniectomy cpt code for strip electrodes is for monitoring the seizures prior to any treatment.
SuperCoder Answered Thu 08th of March, 2018 06:39:47 AM

Hi,

I could not see any list you are referring to? Is there something missing.

Please repost your question..

Thanks,

Supercoder

Denise Posted Thu 08th of March, 2018 10:17:08 AM
1. Placement of CRW Stereotactic Head Frame 2. Stereotactic CT with fusion to preoperative MRI. 3. Stereotactic implantation of Right-Parietal Responsive Neural Stimulation (RNS) Depth Electrode using Stereotactic Head-frame, via a twist-drill burr hole, and using c-arm fluroscopy for positional confirmation 4. Right-Parietal Craniectomy for Implantation of RNS Subdural Strip Electrode 5. Right-Parietal Craniectomy for Implantation of RNS implantable programmable generator (IPG) 6. Connection of Subdural Strip Electrode to Port 1 & Depth Electrode to port #2 of IPG 7. Intraoperative Impedance Testing for confirmation of functioning RNS Device 8. Removal of Headframe
SuperCoder Answered Fri 09th of March, 2018 07:12:50 AM

Hi,

If provider have  implanted two electrode arrays through separate burr holes, you can report both 61863 and 61864. 

For Stereotactic implantation of Right-Parietal Responsive Neural Stimulation (RNS) Depth Electrode  you will report 61863 but if provider is using seperate incision for implanting second RNS Subdural Strip Electrode you need to report with additional array code 61864. But, if provider is placing stip electrode with same incision you will only report 61863. However, if provider is also doing intraoperative microelectrode recording you will report it with code 61867(Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array ) and 61868 not with 61863. Also, report additional code for IPG 61885 or 61886 as per the documentation. Please refer to operative report for appropriate code selection. 

Hope that helps!

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