CP Angle vs Skull Base Codes

Question:

I just got a case where the neurosurgeon and ENT want to bill the following codes:

ENT, 61596, Transcochlear posterior fossa skull base code for the approach.

Neurosurgeon, 61616, intradural resection of a posterior fossa skull base tumor

Is this correct? The diagnosis is a right translabyrinthine approach to cerebellopontine angle and internal auditory canal with resection of vestibular schwannoma.

Answer:

CP angle tumors, for example vestibular schwannomas, treated via a translabyrinthine approach/exposure have a CPT code that specifically describes the work and value of this approach and resection. That code is61526, Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor.The resection is essentially in the posterior fossa however, since it has a code specifically developed and valued for this procedure, code 61526 must be used. It is valued to reflect the work of this complex resection.

*This response is based on the best information available as of 03/30/23.