AHA Coding Clinic® for HCPCS - 2013 Issue 3; Ask the Editor

Ligation of the ventriculoperitoneal shunt

The patient has a long history of pseudotumor cerebri and several shunts. The patient presents to have the ventriculoperitoneal (VP) shunt ligated (tied off) first as long as her symptoms remain stable, opting for removal at a later date. An incision was made and dissection carried down to the valve and distal tubing. Once the scar tissue around the VP shunt system was mobilized a 2-0 silk tie was securely placed around the distal catheter to occlude the system. The wound was irrigated and closed in multiple layers. Is this procedure considered a revision of the shunt system? Is CPT code 62230, Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system, the appropriate code for ligation of the VP shunt system? ...

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