Category: Neurosurgery

Billing for Hospital NP/PA Consults
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Billing for Hospital NP/PA Consults

July 11, 2019 Question: I heard you speak at the recent AANS coding course – you were awesome and the course was fantastic…everyone should go.  The surgeon I work with has a question regarding billing. Some of the hospitals in the area have a Nurse Practitioner or Physician Assistant on staff that see Neurosurgery consults...

Prescription Refill Visits
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Prescription Refill Visits

June 20, 2019 Question: We get calls from patients to renew their medications.  When the patient comes to office to pick up prescription, can we bill for a nurse visit with 99211? Answer: No.  CPT makes it very clear that picking up a prescription does not constitute a billable E/M service. *This response is based...

Intraoperative Ultrasound for Tumor Removal
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Intraoperative Ultrasound for Tumor Removal

June 6, 2019 Question: My surgeon uses the intraoperative ultrasound to assist with a brain tumor removal. I am billing 76998 with modifier 26 for the professional component.  Sometimes we don’t get paid.  Should I appeal these denials? Answer: No….actually, intraoperative ultrasound is included in the global surgical package for the neurosurgeon and should not...

Coding for Platelet-Rich Plasma Injections in the Spine
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Coding for Platelet-Rich Plasma Injections in the Spine

May 23, 2019 Question: We are starting to do platelet-rich plasma injections in the spine.  Would we bill 64483?  Answer: No because 64483 is specifically for an “anesthetic agent and/or steroid” injection.  The most accurate code is 0232T (Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed).  Be sure to...

63042
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63042

April 25, 2019 Question: When would I ever use 63042?  I am not sure I understand the meaning of this code. Answer: Good question!  CPT 63042 (Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar) is used when the diagnosis is recurrent herniated...

Diagnosis Code Incompatibility
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Diagnosis Code Incompatibility

April 11, 2019 Question: We are being told by our billing service that “CPT 22551 as the procedure/diagnosis code combination is not compatible” when we use the diagnosis code of M50.11 for an ACDF at C3 -4.  This is the first time that we have ever had an issue with M50.11 for 22551.  Is there...

Skull Base Surgery
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Skull Base Surgery

March 28, 2019 Question: My neurosurgeon did a craniotomy with removal of a frontotemporal meningioma with stereotactic navigation and the microscope.  I coded as 61512, 61781, and 69990-59. However, my doctor disagrees and wants to code as 61583, 61512-51.  What do you think? Answer: First, 61583 – a skull base surgery approach code that requires...

Diagnosis Code for Post Op Visits
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Diagnosis Code for Post Op Visits

March 14, 2019 Question: What’s the best way to do the diagnosis coding for postop visits? I mean, does it really matter since we aren’t billing for a visit? Answer: The ICD-10-CM guidelines for postop/aftercare include the following: If the original diagnosis is trauma (eg, using an S diagnosis code) or a code that requires...

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