Sublabial Transphenoidal Hypophysectomy done stereotactically

61548 is the correct code for this procedure when it is done nonstereotactically. But what if they did use stereotactic guidance? Can 61548 & 61781 or 61782 be billed together? Thanks!

Sublabial Transphenoidal Hypophysectomy done stereotactically

Yes, 61548 may be reported with one of the stereotactic navigation codes (61781 or 61782).

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com

re: Sublabial Transphenoidal Hypophysectomy done stereotactically

Hi Kim,
I billed CPT® 62223 amd 61782. Of course, Humana denied CPT® 61782. They stating that we never billed the primary procedure. Couldn't CPT® 62223 be a primary procedure and if so, where do I find proof of this?

Please advise,
Thank you!

re: Sublabial Transphenoidal Hypophysectomy done stereotactically

Code 61782(A surgical technique that uses medical imaging to precisely locate in three dimensions an anatomical site to which a surgical instrument or a beam of radiation is directed. Also called stereotactic surgery.)
is a add on code and can only be billed with in the catergory of codes that is falls in, in the CPT® book. You cannot take a code from another section of the CPT® book and use it w/another CPT® code as the primary code. So to bill 61782 you must use 61770 as it has to do with the localzation of where the radiation is being directed(crainal, intradural or cranial, extradural or spinal.

Code 62223 is for creating shunts to form communicating ducts to help create the flow of CSF. 62223 is if its located at the plueral space. your CTP book explains all of this. again you cannot take codes out of seequence in the CPT® book.

re: Sublabial Transphenoidal Hypophysectomy done stereotactically

Thank you! IKWilliams.. understood now.

re: Sublabial Transphenoidal Hypophysectomy done stereotactically

your so very welcome, glad I could be of help:)

re: Sublabial Transphenoidal Hypophysectomy done stereotactically

Hi IKwilliams,

Sorry to bother you but I went onto Medtronics, there website for my source is : http://www.medtronic.com/wcm/groups/mdtcom_sg/@mdt/@ent/documents/documents/ent-casn-coding.pdf.

They stated that CPT® 61782 is : Computer Assisted Surgical Navigation System, also known as CASN,
Stereotactic Guidance System, or Image Guided Surgery, may be
used for surgical navigation around high-risk anatomical areas. CASN
provides surgeons with a more detailed view of structures in intricate
areas near the eyes, blood vessels and nerves that they may encounter
during primary procedures. By improving the surgeon’s ability to judge
the location of instruments relative to the anatomic structures during
the primary procedure, CASN allows surgeons to potentially avoid
complications in these critical areas.

Also in the CPT® book, it does not state that this code is only used for placement of radiation source. Plus this code replaces 61795, stating that code was used for brain surgery using a computer. You mention in your answer that you can't take a code from another section and apply it to the code we are using which is 61500. Not sure why i said 62223. Anyways.. The CPT® Book does not specify which codes are primary, and I do feel that we coded correctly. CPT® 61500 does not include any sterotactic planning, which can be up two hours. Would love to hear back from you? Or anyone reading this message.
Thanks!