DRG Coding Advisor
New codes for stereotactic radiosurgery
By Rita A. Scichilone, MHSA, RRA, CCS, CCS-P
Professional Management Midwest
Omaha, NE
For FY 1999 there are new codes in category 92.3 for procedures involving stereotactic radiation use in surgery. This is performed to treat benign and malignant brain tumors and arteriomalformations.
Stereotactic biopsy procedures are excluded from this category, and are coded to the specific anatomical site, as they always have been. The new codes are as follows:
• 92.30 — stereotactic radiosurgery not otherwise specified;
• 92.31 — single source photon radiosurgery (a form using one beam of radiation that is retargeted by using a moving gantry, such as linear accelerator [LINAC]);
• 92.32 — multisource photon radiosurgery (a form using multiple beams surrounding the target, such as Cobalt 60 radiation and gamma radiation);
• 92.33 — particulate radiosurgery (a form using a particle beam source modulated to deliver a high dose at the target, such as cyclotron or proton accelerator);
• 92.39 — stereotactic radiosurgery not elsewhere classified.
Remember the difference between not otherwise specified (NOS) and not elsewhere classified (NEC) when coding in ICD-9-CM. NOS means there is not enough information in the record to classify the procedure to an existing code. NEC means the details of the procedure are available in the record, but no category exists that specifically fit the procedure performed.
This procedure allows very precise delivery of radiation to the tissue. Tools for localization of the target include the stereotactic head frame, a CT or MRI scanner, a computerized system to calculating the dose of radiation, and the system to deliver the radiation. Radiosurgery sometimes is used in the treatment of functional disorders such as Parkinson's and intractable epilepsy.
These procedures are not considered valid OR procedures for DRG purposes, so the cases will be grouped according to the diagnoses present.
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