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Neurosurgery Coding Alert

Reader Questions:

Mind (Notes) to Nail Cath Placement

Question: Encounter notes indicate the provider replaced a distal catheter in a cerebrospinal fluid shunt system. During the procedure, they also placed a neuroendoscopic ventricular catheter. Should I report 62230 for this service? It doesn’t seem to cover the cath placement.

Florida Subscriber

Answer: Yes, you should report 62230 (Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system) along with +62160 [Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure)].

Your coding was slightly off, perhaps because you missed the parenthetical guidance below the code descriptor.

Beneath the code descriptor for 62320, CPT® offers this guidance: “For intracranial neuroendoscopic ventricular catheter placement, use +62160 [Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure).”

Also, the 62230 entry has this guidance: “For replacement of only the valve and proximal catheter, use 62230 in conjunction with 62225 [Replacement or irrigation, ventricular catheter].)