You should ever use these codes for open surgery and endoscopy together.
In case your neurosurgeon carries out neuroendoscopy services during cranial procedures, you must never report the service with open procedures or else you might end up missing on reimbursement opportunities. Read this article to side-step errors in medical coding.
Codes to remember: While reporting the neuroendoscopy procedures, you will require choosing from the CPT codes 62161 (Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts [including placement, replacement or removal of ventricular catheter]) – 62165 (Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach) and the add-on code + 62160 (Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage [list separately in addition to code for primary procedure]).
1. Segregate Endoscopy from Open Codes
The surgeon may adopt either of the two choices to treat the problem, but he will never use both of them at the same time. He may either insert an endoscope to treat the underlying condition or may adopt an open approach for instance the affected area is surgically opened up to address the pathology. Neuroendoscopy CPT codes are definitive and independent. So, you cannot report neuroendoscopy codes with codes for parallel open procedures.
Example: In case your neurosurgeon undertakes an open approach to obliterate a supratentorial tumor which is not a meningioma, you would report 61510 (Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma). On the other hand if he adopts a neuroendoscopic procedure to accomplish the excision of the tumor, you would report 62164(Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage). This includes placement of a ventricular catheter for drainage.
Cautionary tip: You must be cautious to not report the codes for open and neuroendoscopic stand-alone procedures at the same time. Remember that you cannot report 61510 and 62164 together. The reason being that in one session, the surgeon can adopt either approach but not both to address the underlying pathology.
Exception: If your surgeon provides a detailed explanation of an accompanying procedure in the operative note, you can report 62160. CPT® allows this add-on code to be reported with primary procedure CPT codes like 62220, 62223, 62225 and 62230. CPT® made the neuroendoscopy codes to stand apart from open procedures, again, with the exception of 62160.
2. Beware the Bundles
You must never report a twist drill, cranial burr hole, or trephine along with the neuroendoscope code; NCCI bundles these access CPT codes with the endoscopy itself. The burr hole is assumed or included in the neuroendoscopy code(s), as you can’t do the neuroendoscopy excluding a burr hole, however you can do a burr hole excluding neuroendoscopy. In case twist drill, cranial burr, or trephine are carried out at the same time neuroendoscopy is, you would report only neuroendoscopy
In case your neurosurgeon carries out neuroendoscopy services during cranial procedures, you must never report the service with open procedures or else you might end up missing on reimbursement opportunities. Read this article to side-step errors in medical coding.
Codes to remember: While reporting the neuroendoscopy procedures, you will require choosing from the CPT codes 62161 (Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts [including placement, replacement or removal of ventricular catheter]) – 62165 (Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach) and the add-on code + 62160 (Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage [list separately in addition to code for primary procedure]).
1. Segregate Endoscopy from Open Codes
The surgeon may adopt either of the two choices to treat the problem, but he will never use both of them at the same time. He may either insert an endoscope to treat the underlying condition or may adopt an open approach for instance the affected area is surgically opened up to address the pathology. Neuroendoscopy CPT codes are definitive and independent. So, you cannot report neuroendoscopy codes with codes for parallel open procedures.
Example: In case your neurosurgeon undertakes an open approach to obliterate a supratentorial tumor which is not a meningioma, you would report 61510 (Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma). On the other hand if he adopts a neuroendoscopic procedure to accomplish the excision of the tumor, you would report 62164(Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage). This includes placement of a ventricular catheter for drainage.
Cautionary tip: You must be cautious to not report the codes for open and neuroendoscopic stand-alone procedures at the same time. Remember that you cannot report 61510 and 62164 together. The reason being that in one session, the surgeon can adopt either approach but not both to address the underlying pathology.
Exception: If your surgeon provides a detailed explanation of an accompanying procedure in the operative note, you can report 62160. CPT® allows this add-on code to be reported with primary procedure CPT codes like 62220, 62223, 62225 and 62230. CPT® made the neuroendoscopy codes to stand apart from open procedures, again, with the exception of 62160.
2. Beware the Bundles
You must never report a twist drill, cranial burr hole, or trephine along with the neuroendoscope code; NCCI bundles these access CPT codes with the endoscopy itself. The burr hole is assumed or included in the neuroendoscopy code(s), as you can’t do the neuroendoscopy excluding a burr hole, however you can do a burr hole excluding neuroendoscopy. In case twist drill, cranial burr, or trephine are carried out at the same time neuroendoscopy is, you would report only neuroendoscopy
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