mid skull tumor

CPT code for following surgery:

The patient was brought to the operating room and
placed supine on the operating table. After adequate intravenous and
inhalational anesthesia had been achieved, she was administered
intravenous antibiotics and 200 mg of hydrocortisone.

Next, her head was placed in a three pin Mayfield clamp and slightly
turned to the right. Care was taken to assure all pressure points were
adequately padded and the table was placed in a reverse Trendelenburg
position. The BrainLAB system was registered to the patient and used
to plan or trajectory through the paranasal sinuses to the skull base.
The patient's nostrils were prepped and draped in the usual sterile
fashion. Additionally, abdomen was prepped and draped in the usual
sterile fashion. Her nostrils were then packed with oxymetazoline
soaked pledgets.
The oxymetazoline pledgets were removed and a 0 degree endoscope was
placed in the right nostril. The anatomy was inspected and in standard
fashion, the right middle turbinate was resected. Next, the sphenoid
ostium was visualized and this was opened using Tru-Cut rongeurs and
punches. The BrainLAB system was used to confirm our trajectory
through the paranasal sinuses to the skull base.
Next, a Freer elevator was used to incise the posterior aspect of
nasal septum along the junction of the bony septum. The bony septum
was then taken down with high speed drill, Tru-Cut rongeurs and
Kerrison punches. Next, we proceeded to open the face of the sphenoid
sinus widely. Blakesley forceps were used to take down the mucosa in
doing so, we had gained access to the skull base and visualized it
from one carotid to the other as well as from the ethmoid sinuses down
to the clivus.
Using a high speed drill, the midline skull base floor was drilled
out. The dura was then opened sharply with endoscopic knife and tumor
was encountered. Using endoscopic visualization, curettes and suction
the tumor was resected from the sella, suprasellar and parasellar
regions as well as the supraclinoid area and the cavernous sinuses
bilaterally. Once we had achieved a gross total resection, the dura
was closed with Tisseel. The wound was copiously irrigated out. Next,
a NasoPore dressing was placed in the right nostril and bacitracin
ointment was placed in both nostrils. A mustache dressing was
applied.

[horselip]

Not clear on the question?

[rumpled]

Sounds like a surgical report for a endoscopic pituitary surgery (after all, they look at the abdomen as well in case they need a fat graft) but I agree with Horsey - I don't see a question.

[lori7576]

A CPt code is need it but the physician doesn't agree with 62165, need a different option. Thank you.

[horselip]

I don't CPT codes..sorry. Is the physician asking the patient for it? That's strange? I'm not a medical biller just a patient.

[mkh9]

Yes, what type of tumor did they say you have? Was it malignant? Where exactly was it located. Any information and questions will be helpful.
mkh9

[rumpled]

I agree - coding is a doctor and insurance issue! They have to work that out...
MKH - the tumor was pituitary. It would take a path report to know if it was benign or malignant but odds are super strong, thankfully, that it is benign - however, it will have many effects from the hormones.