© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 61450 refers to a craniectomy performed in the subtemporal region, specifically targeting the sensory root of the Gasserian ganglion, which is also known as the trigeminal ganglion. This ganglion is a critical component of the trigeminal nerve (cranial nerve V), responsible for transmitting sensory information from the face to the brain. The Gasserian ganglion is situated within Meckel's cave, a cavity in the dura mater located near the apex of the petrous portion of the temporal bone. The primary purpose of this surgical intervention is to alleviate pain symptoms that arise from compression of the Gasserian ganglion. During the procedure, a small curvilinear incision is made behind the ear to access the area. The temporal muscle is then divided, and its fibers are carefully separated from the underlying bone to expose the temporal fossa. A small section of the temporal bone is excised to gain access to the sensory root of the Gasserian ganglion. Various techniques may be employed during the procedure, including the division of nerve fibers, the use of a balloon to temporarily compress the nerve root, or the dissection of vascular structures that may be compressing the trigeminal nerve. The latter technique, known as microvascular decompression, is the most frequently performed method. In this approach, blood vessels are meticulously dissected away from the nerve, and a Teflon pad is placed between the nerve and the blood vessels to prevent further compression. After the necessary interventions are completed, the excised portion of the temporal bone is replaced and secured with wire sutures, followed by the closure of the overlying tissues in layers.
© Copyright 2025 Coding Ahead. All rights reserved.
The craniectomy procedure described by CPT® Code 61450 is indicated for the treatment of pain symptoms associated with compression of the Gasserian ganglion. This condition may manifest in various forms, including:
The procedure for CPT® Code 61450 involves several critical steps to effectively address the compression of the Gasserian ganglion. The steps are as follows:
Post-procedure care following a craniectomy for the Gasserian ganglion involves monitoring for any complications, such as infection or cerebrospinal fluid leaks. Patients may experience some swelling and discomfort in the surgical area, which can be managed with appropriate pain relief measures. Recovery time can vary, but patients are typically advised to avoid strenuous activities for a specified period to allow for proper healing. Follow-up appointments are essential to assess the effectiveness of the procedure and to monitor for any recurrence of symptoms. Additionally, patients may be provided with specific instructions regarding wound care and signs of complications to watch for during their recovery.
| Short Descr | CRNEC STPL SCTJ CMPRN/DCMPRN | Medium Descr | CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION | Long Descr | Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion | 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) | 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 | 9 - Other OR therapeutic nervous system 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) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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 |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |