Endoscopic Transnasal Pituitary Tumor Removal

March 30, 2017

Question:
I’m confused.  Should I use 61548 vs 61580 & 61600 to bill an endoscopic transnasal approach to remove a pituitary tumor?  Or is this an unlisted code (64999)?

Answer:
Good question – there are actually 3 CPT codes that specifically address removal of a pituitary tumor none of which are the skull base surgery codes you asked about (61580 & 61600).  They are listed in the table below:

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CPT Code CPT Descriptor  Approach
61546 Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach
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Craniotomy, open
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61548 Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic
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Transnasal or transseptal using a microscope
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62165 Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach Transnasal or trans-sphenoidal using an endoscope
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The codes, 61580 and 61600, are skull base codes which require an open approach and are not used to report transnasal procedures.

So there is a code for the procedure you describe and that is 62165.  Remember to append modifier 62 (two surgeons) if the approach is performed by the otolaryngologist (both surgeons report 62165-62).

*This response is based on the best information available as of 03/30/17.

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