Get Well-Acquainted with Your Craniotomy and Laminectomy Codes
For the patient with a diagnosis of a clinoidal meningioma, your surgeon carried out a stereotactic pterional osteoplastic craniotomy along with resection of clinoidal/sphenoid wing mass. For the microdissection in surgery, he used an intraoperative microscope. Prior to decompressing the superior orbital fissure, the tumor was extirpated through the opticocarotid, carotid "oculomotor, as well asprechiasmatic spaces. Furthermore, your surgeon carried out an intraoperative electrophysiological monitoring by means of SSEPs and motor evoked potentials. How do you report this procedureYou report CPT code 61512 (Craniectomy, trephination, bone flap craniotomy for excision of meningioma, supratentorial). Generally, skull base codes are not reported if a craniotomy code specific to the procedure takes place.
In case there is documentation for a skull base approach, after that you would pair the suitable approach code for the location of the neoplasm (anterior v. middle fossa, intradural v. extradural) with the definitive resection code of the similar anatomical site.
As both microdissection and stereotactic navigation are defined, you may also go ahead and report the add-on CPT codes +69990 (Microsurgical techniques, requiring use of operating microscope [List separately in addition to code for primary procedure]) for the microsurgical dissection and +61781 (Stereotactic computer-assisted [navigational] procedure; cranial, intradural [List separately in addition to code for primary procedure]) for the navigational procedure. Remember that the neurophysiological monitoring can never be reported by a member of the operating team.
Can you bill together for a laminectomy meant for decompression of nerve roots carried out at the same side of spinal cord stimulation (SCS) implant? The patient had a spinal stenosis in the thoracic region and the SCS was placed at the similar level.
The patient's OP report mentions "laminectomy from T9-T10, AMA drill was brought in use to further expand the laminectomy for decompression. A set of instruments was used to accomplish neurolysis at this level
1.Sterilize temperature ≤ 135 °C ,if the temperature is over 135 °C ,the motor will be damaged.
2.Normal bone Craiotomy drill can only hold drill bits less than 6mm,acetabulum reaaming drill with big torque,rpm is around 400,canulate drill is used with nail or K wire ,rpm is around 800.
3.The battery need to be get out of the power tool after surgery.Otherwise the small automatic discharge of the electric will make the life of the battery short.
4.The battery cannot be sterilized ,it is not autoclavable.
5.The cranial bur must be washed right after the surgery by purger in order to avoid the blood stick in the bur,then we should make it dry.
6.The battery space in the handpiece of the tool should not have any water,after sterilization.
7.The cranial bur blade is made of medical stainless steel,in order to avoid broken,so it is flexible and not very hard,it is easy to be attrite,we suggest each blade only use for 1 surgery.
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