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AANS Neurosurgeon | Volume 27, Number 1, 2018


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

When coding for an endarterectomy (35301) can the microscope be billed also 69990? or is that considered inclusive with the 35301 code?  Answer: Yes, but 35301 is not part of the list of codes from CMS where 69990 is covered  Find out more: 

Clemens M. Schirmer, MD, PhD, FAANS

Past Tips
  • 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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