Neurosurgery and Spinal Service Line Part 2

Codes Discussed: ICD-10-PCS (International Classification of Diseases, 10th Revision, Procedure Coding System), 2026 ICD-10-PCS, ICD-10-PCS Official Guidelines for Coding and Reporting, PCS Index and Tables, Medical and Surgical section, Radiation Therapy section, Measurement and Monitoring section, Other Procedures section, Central Nervous System body system, Peripheral Nervous System body system, Head and Facial Bones body system, Anatomical Regions General body system, body system value 00 (Central Nervous System and Cranial Nerves), body system value 01 (Peripheral Nervous System), body system value 0N (Head and Facial Bones), body system value 0W (Anatomical Regions General), Central Nervous System PCS value 0, cranial nerves grouped in Central Nervous System, Cerebral Hemisphere body part value 7, Dura Mater body part value 2, Cerebral Meninges body part, Epidural Space body part, Subdural Space body part, Subarachnoid Space body part, Cerebral Ventricle body part value 6, Cranial Cavity body part, Cranial Nerve body part, Brain body part value 0, Glossopharyngeal Nerve body part value P, Trigeminal Nerve body part value K, Facial Nerve body part value M, Acoustic Nerve body part value N, Vagus Nerve body part value E, Sciatic Nerve body part value F, Femoral Nerve body part, Tibial Nerve body part, Median Nerve body part value 5, Ulnar Nerve body part value 4, Peroneal Nerve body part value H, Thoracic Sympathetic Nerve body part value L, Lumbar Plexus body part, Abdominal Sympathetic Nerve body part, Basal Ganglia body part, Thalamus body part, Occipital Bone body part, Medulla Oblongata body part, Root Operation Excision, Root Operation Resection, Root Operation Destruction, Root Operation Extraction, Root Operation Drainage, Root Operation Extirpation, Root Operation Division, Root Operation Release, Root Operation Transfer, Root Operation Reposition, Root Operation Bypass, Root Operation Insertion, Root Operation Removal, Root Operation Revision, Root Operation Repair, Root Operation Supplement, Root Operation Replacement, Root Operation Inspection, Root Operation Map, Root Operation Introduction, Root Type Stereotactic Radiosurgery, Approach value 0 (Open), Approach value 3 (Percutaneous), Approach value 4 (Percutaneous Endoscopic), Device value J (Synthetic Substitute), Device value K (Nonautologous Tissue Substitute), Device value 7 (Autologous Tissue Substitute), Device value M (Neurostimulator Lead), Device value D (Multiple Array Stimulator Generator), Device value 0 (Drainage Device), Qualifier value 3 (Laser Interstitial Thermal Therapy/LITT in CNS Destruction table), Qualifier value Z (No qualifier), Qualifier value X (Diagnostic), qualifier value 6 (Peritoneal Cavity destination for VP shunt bypass), qualifier value 4 (Ulnar nerve transfer destination in median-to-ulnar nerve transfer), 00T table (Central Nervous System Resection table), 005 table (Central Nervous System Destruction table), 00D table (Central Nervous System Extraction table), 00N table (Central Nervous System Release table), 00W table (Central Nervous System Revision table), 00U table (Central Nervous System Supplement table), 001 table (Central Nervous System Bypass table), 01X table (Peripheral Nervous System Transfer table), 01U table (Peripheral Nervous System Supplement table), 01B table (Peripheral Nervous System Excision table), 01Q table (Peripheral Nervous System Repair table), 4A1 table (Monitoring table for intraoperative monitoring), 8E0 table (Computer-assisted and robotic-assisted procedure table), D020JZZ (Stereotactic gamma beam radiosurgery of brain/frontal lobe epileptogenic zone), 4A1134G (Monitoring of peripheral nervous electrical activity, percutaneous approach, intraoperative/femoral nerve monitoring), 015F3ZZ (Destruction of sciatic nerve, percutaneous approach/radiofrequency treatment for leg pain), 00943ZX (Drainage of subdural space, percutaneous approach, diagnostic/subdural abscess drained via burr hole for culture and sensitivity), 00NP4ZZ (Release of glossopharyngeal nerve, percutaneous endoscopic approach/decompression of ninth cranial nerve), 00SK0ZZ (Reposition of trigeminal nerve, open approach/inferior alveolar nerve repositioning for dental implants), 00163J6 (Bypass of cerebral ventricle to peritoneal cavity with synthetic substitute, percutaneous approach/ventriculoperitoneal shunt placement), 00W63JZ (Revision of synthetic substitute in cerebral ventricle, percutaneous approach/VP shunt ventricular catheter replacement), 00U23JZ (Supplement of dura mater with synthetic substitute, percutaneous approach/Neuro-Patch cranial dura repair through burr hole), 01X50Z4 (Transfer of median nerve to ulnar nerve, open approach/motor branch transfer to restore hand function), 01S50ZZ (Incorrect answer choice because procedure was Transfer, not Reposition), 01WY07Z (Incorrect answer choice because no device was revised), 01X40Z5 (Incorrect answer choice because body part character should describe location at start of transfer), 00970ZZ (Drainage of cerebral hemisphere, open approach/left frontal lobe abscess evacuation), 009630Z (Drainage of cerebral ventricle with drainage device, percutaneous approach/external ventricular catheter placement), 8E09XBH (Computer-assisted procedure of head and neck region, open approach, MRI/Stealth guidance), 009030Z (Incorrect answer choice because lobe/cerebral hemisphere was more specific than brain and drainage catheter was separately coded), 009730Z (Incorrect answer choice because cerebral hemisphere drainage and cerebral ventricle drainage device involve different body parts), 3E1Q38Z (Incorrect answer choice because irrigation is not coded separately when performed with another procedure), 00HE0MZ (Insertion of neurostimulator lead into vagus nerve, open approach/VNS electrode lead placement), 0JH60DZ (Insertion of multiple array stimulator generator into chest subcutaneous tissue and fascia, open approach/VNS generator placement), 00HE02Z (Incorrect answer choice because neurostimulator leads were placed), 00H00MZ (Incorrect answer choice because lead was placed at vagus nerve, not brain), 01HY0MZ (Incorrect answer choice because vagus nerve is a cranial nerve), 01U507Z (Supplement of median nerve with autologous tissue substitute, open approach/sural nerve graft bridge to median nerve), 01BG0ZZ (Excision of tibial nerve, open approach/medial sural cutaneous branch harvest), 01SG0ZZ (Incorrect answer choice because nerve graft was not repositioned), 01B50ZZ (Incorrect answer choice because harvest body part was not median nerve), 01Q50ZZ (Incorrect answer choice because device/graft use makes Repair inappropriate), 01BH0ZZ (Incorrect answer choice because medial sural nerve differs from lateral sural nerve), 00BN0ZZ (Excision of acoustic nerve, open approach/acoustic neuroma debulking), 4A10X4G (Monitoring of central nervous electrical activity, external approach, intraoperative/SSEP monitoring), 00BK0ZZ (Incorrect answer choice because acoustic nerve tumor is coded to acoustic nerve, not trigeminal nerve), 01NH0ZZ (Release of peroneal nerve, open approach/right peroneal nerve decompression), 00C40ZZ (Extirpation of matter from subdural space, open approach/clotted subdural hematoma evacuation), 009400Z (Incorrect answer choice because clotted blood is not drainage and routine operative drains are not coded), 00C43ZZ (Incorrect answer choice because clot evacuation site was exposed/open, not percutaneous), 00940ZZ (Incorrect answer choice because clotted blood is solid matter, not drainage), 0LQ80ZZ (Repair of left hand tendon, open approach/flexor digitorum profundus tendon repair), 01Q40ZZ (Repair of ulnar nerve, open approach/ulnar digital nerve suture repair), 01BL0ZZ (Excision of thoracic sympathetic nerve, open approach/thoracic sympathectomy), 01B80ZZ (Incorrect answer choice because thoracic sympathetic nerve was excised), 01B30ZZ (Incorrect answer choice because thoracic sympathetic nerve was excised), 005K3ZZ (Destruction of trigeminal nerve, percutaneous approach/radiofrequency coagulation for trigeminal neuralgia), 005K4ZZ (Incorrect answer choice because no endoscope was used), 005K0ZZ (Incorrect answer choice because procedure was percutaneous), CUSA (Cavitron ultrasonic surgical aspiration), LITT (Laser interstitial thermal therapy), VP shunt (Ventriculoperitoneal shunt), VNS (Vagal nerve stimulator), ECoG (Electrocorticogram), EEG (Electroencephalogram), SSEP (Somatosensory evoked potentials), CSF (Cerebrospinal fluid), Gamma Knife surgery, Xknife surgery, CyberKnife surgery, stereotactic radiosurgery, gamma beam radiosurgery, Stealth navigation, MRI-guided stereotactic image guidance, computer-assisted navigation, robotic-assisted surgery, intraoperative monitoring, subdural electrodes, monitoring leads, neurostimulator leads, multiple array generator, Delta valve, Rickham reservoir, ventricular catheter, distal catheter, antibiotic-coated ventricular catheter, external ventricular catheter, drainage device, Rickham, Neuro-Patch, nerve graft, nerve conduit, autologous graft, nonautologous nerve graft, synthetic nerve conduit, cadaver nerve, sural nerve graft, medial sural cutaneous branch, Duragen-type patch concept, fibrin glue, Gelfoam, Gelfoam over dural closure, Nurolon sutures, nylon stitches, Gelfoam, mini plates, screws, burr hole, craniotomy, craniectomy, bone flap, skull flap, high-speed burr, operating microscope, Mayfield frame, Silastic loop, radiofrequency needle, fluoroscopic guidance, gamma rays, collimator, local anesthesia, moderate sedation

Topics Covered: ICD-10-PCS Neurosurgery Part 2, neurosurgery and spinal service line Part 2, central nervous system anatomy, peripheral nervous system anatomy, cranial nerve coding, nervous system PCS body part values, Body Part Key use, central nervous system body system coding, peripheral nervous system body system coding, head and facial bones coding, anatomical regions general coding, cranial cavity body part coding, cerebral hemisphere coding, brain lobe coding, cerebral meninges coding, dura mater coding, epidural space coding, subdural space coding, subarachnoid space coding, pia mater, arachnoid mater, dura mater, superior sagittal sinus, false cerebral fissure, periosteum, bone of skull, skin of scalp, skull anatomy for neurosurgery, brain protective bones, frontal bone, occipital bone, craniotomy coding, craniectomy coding, skull bone flap replacement, skull bone flap storage, subcutaneous abdominal pocket for bone flap, closure with plates and screws not separately coded, peripheral somatic nerves, autonomic nerves, sympathetic nerve pathways, nerve plexus coding, closest proximal branch guideline, Guideline B4.2 branch body part selection, cervical nerve coding, thoracic nerve coding, lumbar nerve coding, sacral nerve coding, lumbar plexus, abdominal sympathetic nerve, accessory obturator nerve, celiac plexus, globus pallidus, basal ganglia, occipital lobe, cerebral hemisphere, geniculate nucleus, thalamus, foramen magnum, occipital bone, pneumogastric nerve, vagus nerve, myelencephalon, medulla oblongata, removing body parts in neurosurgery, draining nervous system structures, separating nervous system body parts, open drainage procedures, percutaneous drainage procedures, brain tumor excision coding, meningioma coding, nerve lesion excision coding, malignant nervous system tumor removal, benign tumor observation, partial hemispherectomy coding, choroid plexus tumor coding, cerebral ventricle tumor coding, papilloma of choroid plexus, choroid plexus carcinoma, nerve lesion closest branch coding, cerebral hemisphere resection, brain lobe excision, peripheral nerve destruction, peripheral nerve division, nerves not resected concept, destruction of nervous system structures, tumor destruction, epilepsy treatment, intractable pain treatment, electrocautery destruction, radiofrequency ablation, neurolytic agent injection, cryoablation, laser interstitial thermal therapy, LITT qualifier selection, ultrasound ablation, CUSA coding, Cavitron ultrasonic surgical aspiration, ultrasonic tissue fragmentation, emulsion and aspiration of tissue, extraction in central nervous system, drainage of blood, drainage of cerebrospinal fluid, subdural tap coding, infant fontanelle access, burr hole drainage, craniotomy drainage, brain abscess drainage, brain cyst drainage, liquid hematoma drainage, drainage device coding, solid matter removal, clotted blood extirpation, foreign body extirpation, bullet removal, knife blade removal, liquid versus solid hematoma coding, skull fracture fragment repositioning, Division root operation in neurosurgery, corpus callosum division, corpus callosotomy coding, seizure spread prevention, nerve division for pain control, nerve division for spasticity, radiofrequency ablation versus nerve cutting, Release root operation in neurosurgery, nerve decompression coding, cranial nerve decompression, fifth cranial nerve release, seventh cranial nerve release, ninth cranial nerve release, glossopharyngeal nerve decompression, facial pain procedure coding, throat pain procedure coding, mouth muscular control restoration, peripheral nerve release, median nerve release, ulnar nerve release, tibial nerve release, carpal tunnel release coding, cubital tunnel release coding, tarsal tunnel release coding, nerve being released as body part, sciatic nerve radiofrequency case, sciatic nerve destruction, subdural abscess drainage case, clotted blood extirpation quiz, percutaneous endoscopic glossopharyngeal nerve decompression, tarsal tunnel release of tibial nerve, moving body parts in neurosurgery, altering route of nervous system tubular body parts, Transfer root operation in nervous system, nerve transfer coding, radial to median nerve transfer, median to ulnar nerve transfer, cranial nerve transfer, facial expression restoration after facial nerve injury, transfer body part at procedure start, Reposition root operation in nervous system, inferior alveolar nerve repositioning, trigeminal nerve branch repositioning, dental implant preparation, ulnar nerve movement out of cubital notch coded as Release, Bypass root operation in nervous system, cerebral ventricle bypass, spinal canal bypass, cerebrospinal fluid rerouting, ventriculoperitoneal shunt coding, VP shunt placement, cerebral ventricle to peritoneal cavity bypass, cerebral ventricle to pleural cavity bypass, cerebral ventricle to urinary tract bypass, ventricular catheter, control valve, distal catheter, VP shunt revision, shunt catheter replacement, synthetic substitute in shunt coding, repairing nervous system body parts, inspecting nervous system body parts, devices in neurosurgery, Insertion root operation in neurosurgery, monitoring device insertion, subdural electrode placement, long-term monitoring device, infusion device insertion, antineoplastic infusion device, antispasmodic infusion device, neurostimulator lead insertion, Removal root operation in neurosurgery, drainage device removal, tissue substitute removal, synthetic substitute removal, Revision root operation in neurosurgery, malfunctioning device correction, misplaced device correction, VP shunt component replacement, neurostimulator lead relocation, monitoring device relocation, peripheral nerve repair coding, nerve end preparation, necrotic tissue removal, nerve end reapproximation, nerve alignment, epineural nerve suture repair, nerve repair without device, nerve graft coding, nerve conduit coding, nerve gap bridging, autologous nerve graft, nonautologous nerve graft, synthetic nerve conduit, biological nerve conduit, nerve regeneration scaffold, Supplement versus Replacement for nerve grafts, dural patch coding, cranial dura supplement, spinal dura supplement, dura mater versus spinal meninges body part, dural defect repair, dural patch integral closure rule, Guideline B3.1b integral component coding, arteriovenous fistula repair context, cranial vault procedures, Inspection root operation in neurosurgery, brain inspection, cranial nerve inspection, spinal canal inspection, spinal cord inspection, peripheral nerve inspection, discontinued procedure coding, Map root operation in central nervous system, intracranial EEG coding, ECoG coding, electrocorticogram coding, epileptogenic zone mapping, functional brain area mapping, brain map color documentation, whole brain mapping, cerebral hemisphere mapping, Introduction procedures in neurosurgery, antineoplastic injection into CNS, antibiotic injection into CNS, anti-inflammatory nerve injection, anesthetic nerve injection, intraoperative monitoring coding, computer-assisted surgery coding, robotic-assisted surgery coding, stereotactic radiosurgery coding, radiation therapy for nervous system lesions, Gamma Knife coding, Xknife coding, CyberKnife coding, gamma beam radiosurgery, radiation destroys tumor DNA, collimator helmet, no-incision lesion destruction, Code Purple practice, Code Red Ultimate Challenge, anatomical structure labeling, scalp and cranial meninges diagram labeling, CNS body part matching, peripheral nerve body part matching, sciatic nerve radiofrequency case, subdural abscess burr hole drainage case, cranial nerve decompression case, tarsal tunnel release quiz, trigeminal nerve repositioning case, transfer body part value quiz, VP shunt placement case, VP shunt ventricular catheter revision case, Neuro-Patch cranial dura repair case, epileptogenic zone gamma beam radiosurgery case, femoral nerve intraoperative monitoring case, median nerve to ulnar nerve transfer case, frontal brain abscess drainage case, external ventricular catheter placement, stereotactic MRI-guided Stealth craniotomy, VNS implantation case, vagal nerve neurostimulator placement, vagus nerve lead placement, chest wall generator placement, sural nerve graft harvest case, median nerve graft bridge case, acoustic neuroma debulking case, prior gamma knife surgery history, frameless MRI stereotactic image guidance, operating microscope use, external monitoring leads, acoustic nerve tumor origin coding, peroneal nerve decompression case, right peroneal neuropathy, foot drop, fascial band lysis, subdural hematoma evacuation case, midline shift, cortical arterial bleeder, clotted subdural hematoma extirpation, ulnar digital nerve repair case, flexor digitorum profundus tendon repair, operating microscope nerve repair, thoracic sympathectomy case, Raynaud’s syndrome treatment, thoracic sympathetic chain excision, stellate ganglion preservation, brachial plexus protection, trigeminal neuralgia treatment, trigeminal nerve radiofrequency coagulation, foramen ovale needle placement, fluoroscopic guidance without endoscope, medical coding course content, ICD-10-PCS inpatient procedure coding education, neurosurgery coding education