6 Series - Notes Need To Write
6 Series - Notes Need To Write
6 Series - Notes Need To Write
Chemodenervation:
Certain movement disorders such as dystonia and hemi facial spasm benefit from botulinum
toxin injections selectively targeting the muscles that are affected
Example
Strabismus surgery:
Strabismus surgery is surgery on the extra ocular muscles to correct strabismus, the
misalignment of the eyes
+ 67336 -> placement of adjustable suture (s) during strabismus surgery, including postoperative
adjustment(s) of sutures
+ 67334 -> strabismus surgery by posterior fixation suture technique, when or without muscle recession
Example
Q1. Superior rectus muscle and inferior rectus muscle in this place physician performed strabismus
surgery with scarring of extra ocular muscle?
Q2. 1 lateral rectus muscle and 1 medial rectus muscle with adjustable sutures placed?
Q3. 1 superior rectus muscle and 1 inferior rectus muscle with posterior fixation suture?
Nervous System
Injection, drainage or Aspiration
1. Ventricular puncture through previous burr hole for implanted ventricular catheter
2. Puncture of shunt tubing with radiological supervision and interpretation
Burr Hole:
Is not a surgery itself basically a hole in a skull or cranium to brain surgery for the treatment of
injury / surgical hole made in skull (code ranges: 61120 – 61253) (except code 61215)
Supratentorial
Frontal
Parietal
Temporal
Occipital
Cerebrum
Infratentorial
cerebellum
brain stem
posterior fossa
medulla
spinal cord
If MD performing craniectomy or craniotomy with twist drill, burr hole code only craniectomy or
craniotomy
Subdural hematoma:
1. Patient have temporal brain tumor MD performed craniectomy for tumor removal?
Ans:
2. Patient have Cerebellopontine angle tumor in posterior fossa MD performed craniectomy for
excision of brain tumor?
Ans:
Approach Procedure:
The approach procedure is described according to anatomical area involved, ie, anterior cranial
fossa, middle cranial fossa, posterior cranial fossa, and brain stem or upper spinal cord.
Definitive Procedure:
Describes the repair, biopsy, resection, or excision of various lesions of the skull base and, when
appropriate, primary closure of the dura, mucous membranes, and skin.
Notes:
If approach procedure and definitive procedure are done by the same physician add modifier 51
to approach procedure
Do not append modifier 62 along with skull based surgery codes
Approach procedure and definitive procedure are same side (e.g.) if approach procedure
anterior means definitive procedure also anterior
Approach Procedures:
Definitive procedure
Base of Anterior cranial fossa – 61600 – 61601
Base of Middle cranial fossa – 61605 – 61613
Base of Posterior cranial fossa – 61615 – 61616
1. Dr. Martin performed an excision at middle cranial fossa for a vascular lesion the procedure was
completed in intra dural with dura repair and graft. His partner Dr. sudhir performed an
infratemporal approach with decompression of the auditory canal. How do should report
Dr.martin service?
a. 61590, 61606-51 B. 61606-62 C. 61606 D. 61601
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Coding points
Example:
Patient is having lumbar stenosis with low back pain MD performed epidural steroid injection?
Answer:
{If imaging not used for this service use codes 20552 - 20553}
Example:
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