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CPT® Code 61520 refers to a surgical procedure known as craniectomy for the excision of a brain tumor located in the infratentorial region or posterior fossa, specifically targeting tumors at the cerebellopontine angle. The cerebellopontine angle is a critical anatomical area situated at the junction of the cerebellum and the brainstem, filled with cerebrospinal fluid, and bordered medially by the brainstem, superiorly by the cerebellum, and laterally by the temporal bone. This region is significant as it is the most common site for intracranial posterior fossa tumors, with acoustic neuromas, also known as vestibular schwannomas, being the predominant type. These tumors arise from the acoustic nerve, which is positioned behind the ear and beneath the cerebellum, and are characterized by their slow growth. In addition to acoustic neuromas, other less common tumors may also occur in this area, including various benign tumors and both primary and metastatic malignant tumors. The surgical approach typically involves a retrosigmoid approach, which includes performing an occipital craniotomy to access the tumor. The procedure entails careful dissection and debulking of the tumor, including the removal of the posterior wall of the internal auditory canal to facilitate complete excision of the tumor. The meticulous nature of this surgery is crucial to avoid damage to surrounding structures, such as the brainstem and cranial nerves, particularly the facial nerve (cranial nerve VII). Following the successful removal of the tumor, the surgical site is meticulously repaired, including the closure of the dura and the reconstruction of the craniotomy site.
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The procedure described by CPT® Code 61520 is indicated for the excision of tumors located at the cerebellopontine angle, particularly in cases where the tumor is identified as an acoustic neuroma or other types of tumors that may be benign or malignant. The following conditions may warrant this surgical intervention:
The surgical procedure for CPT® Code 61520 involves several critical steps to ensure the safe and effective removal of the tumor:
Post-procedure care following a craniectomy for tumor excision involves monitoring for any complications, such as infection or cerebrospinal fluid leaks. Patients may experience symptoms related to the surgical site, including pain, swelling, or neurological changes. Recovery typically requires a period of observation in a hospital setting, followed by rehabilitation to address any deficits resulting from the tumor or the surgery itself. Follow-up appointments are essential to assess recovery progress and to monitor for any recurrence of the tumor.
Short Descr | REMOVAL OF BRAIN LESION | Medium Descr | CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM | Long Descr | Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor | 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) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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.
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) |
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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | ET | Emergency services | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | 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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Pre-1990 | Added | Code added. |