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Twist drill hole

Amy Posted Mon 23rd of July, 2012 13:02:13 PM

The notes state "At this point, using a high-speed drill bur, a suboccipital craniotomy was then performed down to the level of the foramen magnum, extending up apprx 3 cm and the width was appx 3 cm. Kerrison punch was then used to complete the ctaniotomy. Once this was done, the microscopr was then crought into the operative field for illumination and magnification."

The notes were coded with '61107'. Would this be correct? Would twist drill and high drill be considered the same...is the microscope a monitoring device? Plese help.

SuperCoder Answered Tue 24th of July, 2012 22:08:25 PM

If he used a twist drill to remove the frontal bone, you should report 61107 (Twist drill hole for subdural or ventricular puncture; for implanting ventricular catheter or pressure recording device). But if he made a burr hole, use code 61210 (Burr hole[s]; for implanting ventricular catheter, reservoir, EEG electrode[s] or pressure recording device [separate procedure]).

Typically, your physician will use the burr hole for more definitive procedures (such as ventriculoperitoneal shunts), and will use the (handheld) twist drill for quick catheterization of the ventricle, because it is packed with the catheter kit. Check the operative report (or consult with your doctor) to see which one applies in this case.

Pay attention to your physician's technique to know whether he created a twist drill or burr hole. Both procedures involve the neurosurgeon drilling a hole in the patient's skull to obtain access during the surgery. To choose the correct code, focus on the hole's size and the surgery's location. Here's how:

• Report a twist drill with 61107 (Twist drill hole[s] for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device).Basically, a twist drill hole is done at the bedside with a handheld drill, It's sometimes done in the OR, but it's usually a smaller hole and is actually cranked by hand.

• When you report a burr hole, use 61210 (Burr hole[s]; for implanting ventricular catheter, reservoir, EEG electrode[s], pressure recording device, or other cerebral monitoring device [separate procedure]).A burr hole is done in the operating room under sterile conditions using a power drill.

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