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AANS Neurosurgeon | Volume 26, Number 3, 2017


Code Red: Essential Coding for Every Neurosurgeon

Twice a month, AANS Neurosurgeon’s Code Red brings neurosurgeons tips for coding various procedures. Check back often for new tips and follow us on Twitter @AANSNeurosurg to receive Code Red in real time.

This Week’s Code Red TWEET

How do we avoid non-payment for 22845 with 22853? Answer: you have to append a -59 modifier on 22845, since it is considered bundled into 22853 and 22854. Find out more:

John Ratliff, MD, FAANS

Past Tips
  • When would it be acceptable to use modifier 22 without being red flagged with the insurers? Answer: You can use -22 but your documentation must clearly support the substantial additional work and the reason for the additional work 
  • Coding for intraop data review and electrophysiology? Answer: The surgeon does not code for intraoperative SSEP, EMG or other neuromonitoring  
  • Two surgeons, how do you bill? A: Depends on the procedure and the roles and specialties of the surgeons. A -62 modifier can be used in surgeons of different specialties. See page 112-114 of the handbook for more details: 
  • When is it okay to un-bundle 61107 from the craniotomy/ craniectomy? #AANSCodeRed Answer: Placing a monitor via a separate incision can be coded separately but the need for and use of a separate and distinct skin incision has to be documented @AANS #RealCodingQuestion
  • If a rehab facility I have privileges at consults me for a postop patient in postop global, can I bill for the consult? #AANSCodeRed Answer: No the global period extends across facilities or practice settings @AANS #RealCodingQuestion
  • Can you bill for treatment of vasospam, 61650 when also treating the same vascular territory you are doing a coiling? #AANSCodeRed Answer: If vasospasm is a separate and pre-existing condition then yes, if vasospasm arose during coiling then no @AANS #RealCodingQuestion
  • What ICD-10 code is used when documentation states hydrocephalus following Interventricular Hemorrhage? #AANSCodeRed Answer: G91.4 @AANS #RealCodingQuestion
  • Why do some companies pay 69990 with 63030 and some don’t? What is the recourse if some don’t?  #AANSCodeRed Answer: CPT guidelines allow for reporting of +69990 but 63030 is not one of the codes where CMS reimburses +69990.

Clemens M. Schirmer, MD, PhD, FAANS

There is a new ICD-10 code for spinal stenosis with claudication: M48.062. This covers both anatomy and symptomatology and thus appropriate for both E and M and surgical coding.

Jack Knightly, MD, FAANS

Check Out More of AANS Neurosurgeon’s Columns

Exercise for the Surgeon: Part 3

Cautery: Hot Tips for Neurosurgeons


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