© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 61333 involves the exploration of the orbit using a transcranial approach, which is a surgical technique that allows access to the orbit through the skull. This approach can be executed by either removing a section of the frontal bone while preserving the orbital rim or by removing both the frontal bone and the supraorbital arch. The primary purpose of this procedure is to gain access to the superomedial aspect of the orbit, particularly for addressing lesions or defects located at the orbital apex, optic canal, or those that involve both the orbit and adjacent intracranial structures. The surgical process begins with a bicoronal incision, which is made across the scalp, allowing for the reflection of the scalp to expose the underlying structures. The procedure requires careful manipulation of the frontal lobe and the dura mater, ensuring that the surrounding tissues are preserved as much as possible. The removal of the lesion is performed with precision, ensuring that a margin of healthy tissue is included to minimize the risk of recurrence. After the lesion is excised, the surgical team reconstructs the orbit and secures the frontal bone back in place, followed by the repair of the soft tissues and skin. This complex procedure necessitates a thorough understanding of cranial anatomy and meticulous surgical technique to ensure optimal outcomes for the patient.
© Copyright 2025 Coding Ahead. All rights reserved.
The exploration of the orbit via a transcranial approach, as described by CPT® Code 61333, is indicated for various conditions that necessitate direct access to the orbit and surrounding intracranial structures. The following are specific indications for this procedure:
The procedure for exploration of the orbit using a transcranial approach involves several detailed steps, each critical for successful execution:
Post-procedure care following the exploration of the orbit via a transcranial approach is essential for ensuring proper recovery and minimizing complications. Patients are typically monitored for any signs of neurological deficits or complications related to the surgery. Pain management is provided as needed, and patients may require imaging studies to assess the surgical site. Follow-up appointments are crucial for evaluating the healing process and ensuring that there are no issues with the reconstructed orbit or surrounding structures. Additionally, patients may be advised on activity restrictions to promote healing and prevent strain on the surgical site.
| Short Descr | EXPL ORBIT W/REMOVAL LESION | Medium Descr | EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION | Long Descr | Exploration of orbit (transcranial approach), with removal of lesion | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | 21 - Other extraocular muscle and orbit therapeutic procedures |
This is a primary code that can be used with these additional add-on codes.
| 69990 | Addon Code MPFS Status: Restricted APC N ASC N1 PUB 100 CPT Assistant Article 1Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) |
| 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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2025-01-01 | Changed | Short Description changed. |
| 2019-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |