Pre-op diag: recurrent pituitary tumor, grown into right cavernous sinus, the right interpendunclular cistern of the posterior fossa abutting the brainstem. Extension into the clivus inferorly. Tumor is s/p resection 3 times and s/p radiation.
procedure: endoscopic endonasal approach to resection of recurrent pituitary adenoma within the sella.
tumor was resected out of the right cavernous sinus and parasellar region.
tumor was resected from the midline clivus along with partial clival resection.
resection of tumor off the brain stem of the posterior fossa in the interpenduncular cistern.
abdominal fat graft and repair of anterior skull base cerebrospinal fluid leak with nasoseptal vasularized pedicle flap.
mri and ct image guidance, placement of lumbar drain. This is an older claim I am trying to get paid. The previous person coded this: 62165-22, 61618-51, 64999-51, 20925-51. Is this the correct coding? Thank you!