New to Practice Bundle-Code Red Flyer

Code Red Flyer
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The document addresses various coding questions related to neurosurgical procedures. For the first question, when revising hardware and placing new iliac screws, reinsertion or removal procedures should not be reported in addition to the insertion of new instrumentation. The appropriate codes for the new instrumentation would be 22840-22848. <br /><br />In the case of coding a spinal post-op hematoma evacuation, it falls under the category of a deep hematoma of the spine and should be reported using code 21501. The procedure should be appended with a -78 modifier. <br /><br />When coding interspinous process spacer devices used in conjunction with a laminectomy, there are four codes to consider based on whether decompression is performed or not. For procedures with decompression, use 22867 for single level and +22868 for additional levels. For procedures without decompression, use 22869 for single level and +22870 for additional levels. <br /><br />When a spinous process plate is used in a fusion procedure, it should be reported as an unlisted procedure using code 22899. Additionally, any decompression, arthrodesis, and bone graft codes may be reported in addition to the unlisted code. <br /><br />For programming a shunt after surgery, if the patient's follow-up reprogramming occurs during the global timeframe, it should be billed with code 62252 for reprogramming of the programmable cerebrospinal shunt. Modifier 58 should be added to the procedure code to indicate a staged or related procedure during the postoperative period. <br /><br />In the case of performing a revision discectomy at one level and a new discectomy at another level, both codes should be reported. Use code 63042 for the revision discectomy and code 63030-59 for the additional level, appending the -59 modifier to indicate it being performed at another level in the spine. <br /><br />Regarding a 3-month follow-up visit falling outside the 90-day global period, if the visit occurs after the global period, it can be billed with the appropriate E&M code, rather than being considered post-operative care. <br /><br />The document also briefly mentions new E&M coding rules effective from January 2021 that focus on medical decision making, but states that previous documentation rules should be used for coding in 2020. It also addresses coding for placing subdural electrodes and depth electrodes, differentiating between simple, intermediate, and complex laceration repairs, and provides information about additional coding resources.
Keywords
coding questions
neurosurgical procedures
iliac screws
spinal hematoma evacuation
interspinous process spacer
spinous process plate
shunt programming
revision discectomy
follow-up visit
E&M coding rules