Accurate Trigeminal Neuralgia Coding
Location where the surgeon works is your trustworthy option.
Trigeminal neuralgia coding could be confusing once you read the operative note. You will need to detect the site and structure approached by your surgeon. Ensure that you know if your surgeon is aiming at the ganglion or the tract. Read on this expert neurology billing and coding insight to build up your coding skills and earn the payment that you deserve.
Examine Anatomy Basics
Know that the anatomy will ease your code selection. Trigeminal nerve, the biggest cranial nerve, is a mixed nerve through a major sensory component. It essentially supplies the face through the three branches, that is, ophthalmic nerve (V1), maxillary nerve (V2), and mandibular nerve (V3). The three nerves meet at the trigeminal ganglion that has cell bodies of the incoming sensory fibers. Trigeminal ganglion is also termed the semilunar ganglion or the gasserian ganglion.
The gasserian ganglion is a pile of nerve cells where the trigeminal nerve (CN V) divides into the V1, V2 and V3 nerves. It dwells in the Meckel's cave which exists close to the apex of the petrous part of the temporal bone. From the trigeminal ganglion, the central fibers begin as a tract and go down through the pons to the medulla to then lastly cross the midline in the upper spine and then go up to the brain where the sensations are perceived.
While you are reporting percutaneous treatment of trigeminal neuralgia, you will be required to choose from two codes, which are, 61790 (Creation of lesion by stereotactic method, percutaneous, by neurolytic agent [e.g., alcohol, thermal, electrical, radiofrequency]; gasserian ganglion) and 61791 (Creation of lesion by stereotactic method, percutaneous, by neurolytic agent [fr instance, alcohol, thermal, electrical, radiofrequency]; trigeminal medullary tract).
In case the lesion is formed in the brainstem, then you are supposed to use 61791, and in case it is completed in the gasserion ganglion, you will use 61790. One location is the brainstem and the other isn't in the brainstem. The medullary tract exists in the brainstem. Thus you can search for the term 'medullary tract' in the operative note to ensure that the surgeon worked in the brainstem.
Procedure Location is Important
Examine the note for particular details on the location your surgeon created the lesion: in the trigeminal nerve, its ganglion or the nerve tract in the brainstem. You will determine by the explanation of the location of the nerve lesion in the surgeon's documentation. If you don't know about the location, you would not know the right code to bill. Your surgeon will normally approach the gasserion ganglion to do away with the nerve cells so that the patient's pain is alleviated.
Want to have more Neurosurgery Billing and coding expert tips and know everything about neurosurgery CPT codes? Click here to read the entire article and to get access to our monthly Neurosurgery Coding Alert: Your practical adviser for ethically optimizing coding, payment, and efficiency in Neurosurgery Practice
Read more to perfect your neurosurgery billing and coding: http://www.supercoder.com/articles/articles-alerts/nec/coding-made-easy-nail-the-correct-codes-every-time-for-trigeminal-neuralgia-107425/
Trigeminal neuralgia coding could be confusing once you read the operative note. You will need to detect the site and structure approached by your surgeon. Ensure that you know if your surgeon is aiming at the ganglion or the tract. Read on this expert neurology billing and coding insight to build up your coding skills and earn the payment that you deserve.
Examine Anatomy Basics
Know that the anatomy will ease your code selection. Trigeminal nerve, the biggest cranial nerve, is a mixed nerve through a major sensory component. It essentially supplies the face through the three branches, that is, ophthalmic nerve (V1), maxillary nerve (V2), and mandibular nerve (V3). The three nerves meet at the trigeminal ganglion that has cell bodies of the incoming sensory fibers. Trigeminal ganglion is also termed the semilunar ganglion or the gasserian ganglion.
The gasserian ganglion is a pile of nerve cells where the trigeminal nerve (CN V) divides into the V1, V2 and V3 nerves. It dwells in the Meckel's cave which exists close to the apex of the petrous part of the temporal bone. From the trigeminal ganglion, the central fibers begin as a tract and go down through the pons to the medulla to then lastly cross the midline in the upper spine and then go up to the brain where the sensations are perceived.
While you are reporting percutaneous treatment of trigeminal neuralgia, you will be required to choose from two codes, which are, 61790 (Creation of lesion by stereotactic method, percutaneous, by neurolytic agent [e.g., alcohol, thermal, electrical, radiofrequency]; gasserian ganglion) and 61791 (Creation of lesion by stereotactic method, percutaneous, by neurolytic agent [fr instance, alcohol, thermal, electrical, radiofrequency]; trigeminal medullary tract).
In case the lesion is formed in the brainstem, then you are supposed to use 61791, and in case it is completed in the gasserion ganglion, you will use 61790. One location is the brainstem and the other isn't in the brainstem. The medullary tract exists in the brainstem. Thus you can search for the term 'medullary tract' in the operative note to ensure that the surgeon worked in the brainstem.
Procedure Location is Important
Examine the note for particular details on the location your surgeon created the lesion: in the trigeminal nerve, its ganglion or the nerve tract in the brainstem. You will determine by the explanation of the location of the nerve lesion in the surgeon's documentation. If you don't know about the location, you would not know the right code to bill. Your surgeon will normally approach the gasserion ganglion to do away with the nerve cells so that the patient's pain is alleviated.
Want to have more Neurosurgery Billing and coding expert tips and know everything about neurosurgery CPT codes? Click here to read the entire article and to get access to our monthly Neurosurgery Coding Alert: Your practical adviser for ethically optimizing coding, payment, and efficiency in Neurosurgery Practice
Read more to perfect your neurosurgery billing and coding: http://www.supercoder.com/articles/articles-alerts/nec/coding-made-easy-nail-the-correct-codes-every-time-for-trigeminal-neuralgia-107425/