To lesions affecting the deep facial structures that are adjacent to the undersurface of the cranium (i.e., the base of the skull).”ĬPT 61526/61520 were in CPT prior to 1990 which means these procedures were performed prior to the advent of the skull base surgery codes. Prior to the development of innovative surgical approaches This surgery is unique in that it involves operating on a portion of the skull which was inaccessible “In CPT 1994, new codes were added to describe skull base surgery. The Winter's 1993 CPT Assistant states the following about the new, at the time, skull base surgery codes ( The skull base surgery CPT codes (61580–61619) were implemented in 1994 while 61526/61520 were included in CPT prior to 1990. The descriptions for each Current Procedural Terminology (CPT) code are noted below: The bottom line is that it was, and still is, correct to use 6156 and incorrect to use the skull base surgery codes for the majority of vestibular schwannoma surgical procedures performed via the retrosigmoid/suboccipital and translabyrinthine/transmastoid approaches. Obviously my education attempts have failed as so many neurosurgeons are coding incorrectly for vestibular schwannoma surgery. Fortunately, the results are better for the National Surgical Quality Improvement Program (NSQIP) database where only 24% are incorrectly coding but that number is still too high. That 35% of the institutional cohort's vestibular schwannoma procedures were incorrectly coded is also disappointing. The findings were certainly discouraging to me as a consultant who has worked with hundreds of neurosurgeons to optimize coding, documentation, and reimbursement during my 20-year tenure as a faculty for the American Association of Neurological Surgeons (AANS) coding courses. Thank you to the authors for this interesting article.
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