Note: this article originally appeared in the December 2012 issue of Chats. This topic is important and the rules still apply so we are reissuing this article with the author's permission. The references cited have been updated to reflect the current Surgery Codes in Volume I, Appendix K; STORE Surgery Codes.
CRGC runs a query annually to identify brain tumor cases with incorrect surgery codes, based on the the article below. Every year CRGC identifies approximately 100 cases incorrectly coded with the wrong surgery code for brain tumors. REMINDER: Always review a case with a surgery code of 55, as it may not be a true reflection of the surgery performed. The use of surgery code 55 should be the exception, not the rule for coding brain surgery.
Brain and CNS Surgery Codes
Crickett Dyke, CTR
We would like to bring to your attention an issue with the selection of correct surgery codes for Brain and CNS primaries. During a recent review of brain surgery codes by one of the Cancer Registry of Greater California (CRGC) regions, it was noted that there is an overuse of surgery code 55 (defined as ‘gross total resection of LOBE of brain (lobectomy). Nearly all cases reviewed with surgery code 55 were documented on the abstract as only a ‘total resection of brain tumor, mass or lesion’ and a lobe of the brain was NOT removed with the tumor. There were several cases where surgery code 55 was appropriate, and it was properly documented as such on the abstract. This was especially worrisome for benign brain tumors such as meningiomas, since radical surgery would rarely be done for benign meningiomas.
The surgery codes for Brain are found in Volume I, Appendix K.
The surgery code for ALL spinal cord tumors should only be coded to 22 (Resection of tumor of spinal cord or nerve).
Volume I, Appendix K clearly defines the surgery code definitions and the great majority of cases reviewed should have been coded to code 30 for Gross Resection of Tumor rather than code 55.
The brain surgery codes are listed below. Please take time to review each code and the corresponding definition in order to more accurately code surgical procedures for brain and CNS tumors.
This is an important data item and we depend on all of you to capture precise surgery codes for researchers since not all our data items are be visually edited.