Neurosurgical
Reimbursement Codes
To Our Partners in Healthcare
Medtronic has compiled this coding guide as part of our
mission to help you with the diagnosis and treatment of various
neurological conditions, including hydrocephalus, subdural
hematomas, dural lesions, and intraventricular abnormalities.
The information in the guide provides general
reimbursement information to assist in obtaining
coverage and reimbursement for healthcare services.
These coding suggestions do not replace seeking
coding advice from the payer and/or your own coding
staff. The ultimate responsibility for correct coding lies
with the provider of services. Please contact your local
payer for interpretation of the appropriate codes to use
for specific procedures.
PHYSICIAN CODING AND REIMBURSEMENT
Procedure
Shunt and
Catheter
Implantation and
Replacement
Adjunctive
Services
for Shunt
Implantation
Shunt Removal
Shunt Patency
Evaluation
Shunt
Reprogramming
CPT
Description
61107
Twist drill hole(s) for ventricular puncture for implanting ventricular catheter
61120
Burr hole(s) for ventricular puncture (including injection of gas, contrast media,
dye, or radioactive material)
61210
Burr hole(s) for implanting ventricular catheter
61215
Insertion of subcutaneous reservoir, pump or continuous infusion system for
connection to ventricular catheter
62180
Ventriculocisternal shunting
62190
Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular
62192
Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus
62194
Replacement or irrigation, subarachnoid/subdural catheter
62220
Creation of shunt, ventriculoatrial, ventriculojugular, ventriculoauricular
62223
Creation of shunt, ventriculoperitoneal, ventriculopleural, other terminus
62225
Replacement or irrigation, ventricular catheter
62230
Replacement or revision of CSF shunt, obstructed valve or distal catheter
in shunt system
62258
Removal of complete CSF shunt system with replacement
63741
Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other
percutaneous, not requiring laminectomy
61781
Stereotactic computer- assisted (navigational) procedure, cranial, extradural
(List separately in addition to primary procedure)
61782
Stereotactic computer- assisted (navigational) procedure, cranial, extradural
(List separately in addition to primary procedure)
+62160
Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter
and attachment to shunt system or external drainage
62256
Removal of complete CSF shunt system without replacement
61070
Puncture of shunt tubing or reservoir for aspiration or injection
75809-26
62252
Shuntogram for investigation of previously placed shunt e.g. ventriculoperitoneal
Reprogramming of programmable cerebrospinal shunt
PHYSICIAN CODING AND REIMBURSEMENT
Procedure
CPT
Description
62160
Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter
and attachment to shunt system or external drainage
62161
Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum
pellucidum or intraventricular cysts (including placement, replacement, or removal
of ventricular catheter)
62162
Neuroendoscopy, with fenestration or excision of colloid cyst, including placement
of external ventricular catheter for drainage
62163
Neuroendoscopy, with retrieval of foreign body
62164
Neuroendoscopy, with excision of brain tumor, including placement of external
ventricular catheter for drainage
62165
Neuroendoscopy, with excision of pituitary tumor, transnasal or transsphenoidal approach
62200
Ventriculocisternostomy, third ventricle
62201
Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method
+61795
Stereotactic computer assisted volumetric [navigational] procedure, intracranial,
extracranial, or spinal list separately in addition to code for primary procedure
61107
Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting
ventricular catheter, pressure recording device, or other intracerebral monitoring device
61210
Burr hole(s) for implanting ventricular catheter, reservoir, EEG electrode(s), pressure
recording device, or other cerebral monitoring device (separate procedure)
Lumbar Catheter
Placement
62272
Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter)
SEPS Subdural
Evacuation
61108
Twist drill hole for subdural or ventricular puncture; for evacuation and/or drainage
of subdural hematoma
61323
Craniectomy or craniotomy, decompressive, with or without duraplasty, for
treatment of intracranial hypertension, without evacuation of associated
intraparenchymal hematoma; with lobectomy
61322
Craniectomy or craniotomy, decompressive, with or without duraplasty, for
treatment of intracranial hypertension, without evacuation of associated
intraparenchymal hematoma; without lobectomy
62100
Craniotomy for repair of dural /cerebrospinal fluid leak, including surgery for
rhinorrhea/otorrhea
61692
Surgery of intracranial arteriovenous malformation; dural, complex
61690
Surgery of intracranial arteriovenous malformation; dural, simple
Neuroendoscopy
EVD Catheter
Placement
Cranial
Duraplasty/Dural
Repair
PHYSICIAN CODING AND REIMBURSEMENT
Procedure
Cranial Duraplasty/
Dural Repair
CPT
61608
Resection or excision of neoplastic, vascular or infectious lesion of parasellar area,
cavernous sinus, clivus or midline skull base; intradural, including dural repair, with
or without graft
61606
Resection or excision of neoplastic, vascular or infectious lesion of infratemporal
fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or
without graft
61601
Resection or excision of neoplastic, vascular or infectious lesion of base of anterior
cranial fossa; intradural, including dural repair, with or without graft
63710
Dural graft, spinal
63709
Repair of dural /cerebrospinal fluid leak or pseudomeningocele, with laminectomy
63707
Repair of dural /cerebrospinal fluid leak, not requiring laminectomy
63182
Laminectomy and section of dentate ligaments, with or without dural graft, cervical;
more than two segments
63180
Laminectomy and section of dentate ligaments, with or without dural graft, cervical;
one or two segments
61616
Resection or excision of neoplastic, vascular or infectious lesion of base of posterior
cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies;
intradural, including dural repair, with or without graft
61343
Craniectomy, suboccipital with cervical laminectomy for decompression of medulla
and spinal cord, with or without dural graft (e.g., Arnold Chiari malformation)
62143
Replacement of bone flap or prosthetic plate of skull
Spinal Dural Repair
Cranial Flap Repair/
Mesh Implant
CT Scans
MRI
Spinal Puncture
Description
70450-26*
CT, head or brain, without contrast
70460-26*
CT, head or brain, with contrast
70470-26*
CT, head or brain, without and with contrast
70551-26*
MRI, brain, without contrast
70552-26*
MRI, brain, with contrast
70553-26*
MRI, brain, without and with contrast
62270
Spinal puncture, lumbar, diagnostic
62272
Spinal puncture, tx, for drainage of CSF
*NOTE: M
odifier –26 is appended to some codes to indicate that hospital-owned equipment was used so the physician is being reimbursed only for the professional
service of interpreting the results.
Diagnosis Coding
ICD-9-CM has codes for hydrocephalus, depending on its cause.
331.3
Communicating hydrocephalus
331.4Obstructive hydrocephalus
331.5Idiopathic normal pressure hydrocephalus
Code 331.3 is used when hydrocephalus is secondary to another disease process such as meningitis or
subarachnoid hemorrhage. Code 331.5 is the default code for NPH.
When a patient is seen for issues related to shunt function, other codes are used as the principal diagnosis and
hydrocephalus is coded as a secondary diagnosis.
996.2
Mechanical complications of nervous system device, implant, and graft
996.63 Infection and inflammatory reaction due to nervous system device, implant, and graft
996.75 Other complications due to nervous system device, implant, and graft
V53.09 Fitting and adjustment of other devices related to nervous system
Code V53.09 is used for routine programming encounters and routine replacement of shunt components.
HOSPITAL INPATIENT CODING AND REIMBURSEMENT
Procedure
Ventricular Shunt
Revision, Removal,
Irrigation of
Ventricular Shunt
Spinal
Subarachnoid Shunt
ICD-9-CM
Description
02.21
Insertion or replacement of external ventricular drain (EVD), is used for procedures
such as an EVD set-up, placement of a ventricular catheter for drainage or sampling
of cerebrospinal fluid, or for an injection of medication or other substance.
02.22
Intracranial ventricular shunt or anastomosis, includes procedures such as an
insertion of a Holter valve into the intracranial system, a shunt between two
intracranial ventricles, and ventriculocisternostomy.
02.31
Ventricular shunt to structure in head or neck
02.32
Ventricular shunt to circulatory system
02.33
Ventricular shunt to thoracic cavity
02.34
Ventricular shunt to abdominal cavity and organs
02.35
Ventricular shunt to urinary system
02.39
Ventricular shunt to extracranial site NEC
02.41
Irrigation and exploration of ventricular shunt
02.42
Replacement of ventricular shunt (including replacement of valve and/or catheter)
02.43
Removal of ventricular shunt
54.95
Incision of peritoneum (used for revision of the distal end of a ventriculo-peritoneal shunt)
03.71
Spinal subarachnoid-peritoneal shunt
03.72
Spinal subarachnoid-ureteral shunt
03.79
Other shunt of spinal theca
HOSPITAL INPATIENT CODING AND REIMBURSEMENT
Procedure
Spinal Puncture
Ventriculostomy
Procedure
EVD Catheter
Placement
Lumbar Drainage
Procedure
Subdural
Hematoma
Evacuation
Cranial Defect
Repair
Procedure
Creation of Shunt
ICD-9-CM
Description
03.31
Spinal tap
03.39
Other diagnostic procedures on spinal cord and spinal canal structures
01.26
Insertion of the catheter into a cranial cavity
02.20
Ventriculostomy for ventricular drainage
03.99
Spinal Tap for lumbar drainage
432.1
Subdural hemorrhage [subdural hematoma, non traumatic]
438.19
Diseases of the Musculoskeletal System and Connective Tissue
(Other Specified Deformity)
DRG
Description
031
Ventricular shunt procedures WMCC
032
Ventricular shunt procedures WCC
033
Ventricular shunt procedures WO CC/MCC
If code 03.39 is used with a principal diagnosis NPH, the following surgical DRGs are assigned:
Extended
Lumbar Drainage
028
Spinal procedures WMCC
029
Spinal procedures WCC
030
Spinal procedures WO CC/MCC
If code 03.31 is used with a principal diagnosis NPH, the following medical DRGs are assigned:
056
Degenerative nervous system disorders WMCC
057
Degenerative nervous system disorders WOMCC
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as to the correct form of billing or the amount that will be paid to providers
of service.
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LIT59657 2012-235 1.12
Regular Spinal Tap