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Ventriculocisternostomy, specifically the Torkildsen type operation, is a neurosurgical procedure designed to alleviate conditions caused by obstructions in the cerebral aqueduct, which can lead to increased intracranial pressure and hydrocephalus. This procedure involves the placement of a shunt that connects the lateral ventricle of the brain to the cisterna magna, a space located at the base of the skull that contains cerebrospinal fluid (CSF). The primary goal of this operation is to create an alternative pathway for CSF flow, effectively bypassing the obstruction and allowing for proper drainage. The procedure begins with a curved incision in the scalp, which is then flapped forward to provide access to the underlying structures. A craniotomy is performed to expose the dura mater, the protective covering of the brain. Once the dura is incised, a Torkildsen shunt is inserted into the lateral ventricle, with the distal end of the catheter positioned in the cisterna magna. Although this technique was once a common approach for treating obstructive hydrocephalus, it has largely been supplanted by more advanced procedures, such as neuroendoscopic third ventricle ventriculocisternography, which offer less invasive options and improved outcomes.
© Copyright 2025 Coding Ahead. All rights reserved.
Ventriculocisternostomy (Torkildsen type operation) is indicated for the following conditions:
The procedure for ventriculocisternostomy involves several critical steps to ensure successful placement of the shunt:
After the ventriculocisternostomy procedure, patients are typically monitored for any signs of complications, such as infection or shunt malfunction. Post-operative care may include pain management and monitoring of neurological status to ensure that the shunt is functioning properly. Recovery time can vary, but patients are generally advised to follow up with their healthcare provider to assess the effectiveness of the procedure and to manage any potential issues that may arise. It is important for patients to be aware of the signs of complications, such as headaches, nausea, or changes in consciousness, and to seek medical attention if these occur.
| Short Descr | ESTABLISH BRAIN CAVITY SHUNT | Medium Descr | VENTRICULOCISTERNOSTOMY | Long Descr | Ventriculocisternostomy (Torkildsen type operation) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 2 - Insertion, replacement, or removal of extracranial ventricular shunt |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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