Post by Erin
In a specific scenario, the neurosurgeon carried out a cranial expansion in a longstanding hydrocephalus that was not controlled by shunts. Following removing the sagittal bone over the sagittal sinus, he circumferentially thinned the inner table underneath the frontal and parietal regions. A decompressive subtemporal craniectomy was carried out and the cranial bones had been returned in hinge fashion with resorbable plating program. The pre-op and post-op diagnosis reads 'headaches, likely raised intracranial pressure.' Is ICD code 784 correct for this situation? Can 61322 (Craniectomy or craniotomy, decompressive with or minus duraplasty, for treatment of intracranial hypertension, without having evacuation of connected intraparenchymal hematoma without lobectomy), 61340 (Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)) and 61559 (Extensive craniectomy for many cranial suture craniosynostosis (example, cloverleaf skull) recontouring with several osteotomies and bone autografts (example, barrel-stave process) (includes obtaining grafts) be billed together for this procedure?The code 61322 is meant for use in acute increased intracranial pressure such as after large stroke or traumatic brain injury, or traumatic brain injury, and as such does not apply in this clinical scenario. 61340 (Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) aptly reflects the subtemporal decompression performed for longstanding hydrocephalus. Whilst resection of the sagittal suture indicates consideration of 1 of the craniectomy codes for craniosynostosis, the patient's condition as described is not connected to premature suture fusion. As a result, one need to use the unlisted code 64999 to mirror the excision of the sagittal suture and the thinning of the bony frontal and parietal inner tables. Here the ICD-9 code would be one for hydrocephalus (331.three to 331.9), depending on the kind and trigger for hydrocephalus. The symptom of headaches in this case wouldn't be coded separately. For more on this and for other specialty-certain articles to assist your neurosurgery coding, sign up for a good medical coding resource like Coding Institute.
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