December 3, 2020 Question: What’s the best way to code a retrosigmoid approach and removal of a meningioma at the cerebellopontine angle? Should I use 61519 or 61520? Answer: CPT 61520 (Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor) is more accurate since it better describes the location of the...
November 12, 2020 Question: I heard that the E/M code guidelines are changing in 2021. Will this apply to all E/M codes? Answer: Good question. The 2021 changes will NOT apply to all E/M codes. The 2021 changes apply only to the new patient, 9920x, and established patient, 9921x, categories of codes. That means you...
October 29, 2020 Question: We placed an ICP monitor on the left side of the cranium and a right ventriculostomy, both using the twist drill. We know to use CPT 61107 but wondered about using modifier 50 (bilateral procedure). Thoughts? Answer: Medicare does not recognize modifier 50 on 61107, though some payors might or may...
October 15, 2020 Question: I did an emergency craniectomy on a stroke patient 4 months ago. It is now time to reconstruct the defect and I’ll be doing that by placing some mesh and screws with Methyl methacrylate. Should I be using the 62140/62141 code series? Answer: Actually, CPT considers what you are doing to...
October 1, 2020 Question: How do I code for repair of wound dehiscence with deep abscess status post ACDF (anterior cervical discectomy, decompression and fusion)? I looked at 22010 but that’s for a posterior procedure. Answer: Take a look at 21501 (Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax) to...
September 17, 2020 Question: I just signed up for your 2021 E/M webinar – I’m so excited! Will these changes apply to inpatient codes too? Answer: Great – I look forward seeing you! At this time, the changes are only for new patient and established patient codes – office services. Learn more from Kim Pollock...
September 3, 2020 Question: I work with a neurosurgeon and we don’t see many Medicare patients. The neurosurgeon believes the revised 2021 E/M guidelines will not impact our office practice because of our low Medicare volume. Is this correct? Answer: This is not correct! The revised documentation requirements are from CPT – the coding rule....
August 20, 2020 Question: What if we have to re-program a VP shunt during the global period because the settings need to be adjusted – can we bill for it or is it considered part of the 90-day post-operative global period? Answer: Good question. The initial shunt programming, at the time of insertion, is included...
August 6, 2020 Question: How do I code for repair of a C6-7 fracture/dislocation where I did a laminectomy for decompression to repair the fracture as well as an arthrodesis? Answer: You’ll use CPT 22326 (Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical) for the...
July 23, 2020 Question: I did a craniotomy for removal of a tumor but it had a hemorrhagic component to it so I also removed the hematoma. Can I code for both the tumor removal and removal of intracerebral hematoma? Answer: No – the hematoma removal is considered “incidental” to the tumor removal. Therefore, you’d...
