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Subtemporal cranial decompression is a neurosurgical procedure aimed at alleviating elevated intracranial pressure in the temporal lobe of the brain, specifically in cases of slit ventricle syndrome and pseudotumor cerebri. This procedure involves the surgical removal of the lateral wall of the middle cranial fossa, which is the area of the skull that houses the temporal lobe. Slit ventricle syndrome is a condition characterized by the presence of very small, slit-like ventricles in the brain, often resulting from previous treatments for hydrocephalus, such as the placement of shunts to drain cerebrospinal fluid (CSF). Pseudotumor cerebri, also known as idiopathic intracranial hypertension, is a disorder marked by increased intracranial pressure without an identifiable cause, leading to symptoms such as headaches, visual disturbances, and swelling of the optic disc, known as papilledema. If left untreated, papilledema can result in optic nerve compression and potential blindness. The subtemporal cranial decompression procedure is rarely performed today, as it has largely been supplanted by other treatment options that may be less invasive or more effective in managing these conditions.
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The subtemporal cranial decompression procedure is indicated for specific conditions that result in elevated intracranial pressure. The following are the primary indications for this surgical intervention:
The subtemporal cranial decompression procedure involves several critical steps to effectively relieve pressure in the temporal lobe. The following outlines the procedural steps:
After the subtemporal cranial decompression procedure, patients typically require monitoring for any signs of complications, such as infection or cerebrospinal fluid leakage. Recovery may involve a hospital stay for observation, and patients may be advised to limit physical activity during the initial healing phase. Follow-up appointments are essential to assess recovery and monitor for any recurrence of symptoms related to elevated intracranial pressure. The surgical site will need to be kept clean and dry, and any sutures will be removed during a follow-up visit as directed by the healthcare provider.
| Short Descr | SUBTEMPORAL CRANIAL DCMPRN | Medium Descr | SUBTEMPORAL CRANIAL DECOMPRESSION | Long Descr | Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) | 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 | 1 - Incision and excision of CNS |
This is a primary code that can be used with these additional add-on codes.
| 61316 | Addon Code MPFS Status: Active Code APC C Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) | 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). | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2025-01-01 | Changed | Short Description changed. |
| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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