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The procedure described by CPT® Code 61531 involves the subdural implantation of strip electrodes for the purpose of long-term seizure monitoring. This technique is utilized to gather critical data regarding the electrical activity of the brain, particularly in patients who experience seizures. The strip electrodes, which consist of a single row of electrodes, are strategically placed in the subdural space through one or more burr or trephine holes. The process begins with an incision in the scalp, which is then flapped forward to provide access to the underlying structures. A burr hole is created using a surgical drill or perforator, or alternatively, a small disc of bone may be removed using a trephine. Once access to the subdural space is achieved, the dura mater, which is the outermost layer of the meninges surrounding the brain, is incised. To manage any bleeding that may occur during the procedure, electrocautery is employed. After the strip electrode is inserted into the subdural region, it is tested to confirm its proper functioning. Following the successful placement and testing of the electrode, the dura is closed, and the skull defect is repaired by either replacing the bone disc or applying bone wax. This procedure may be repeated at each site where a strip electrode is implanted, allowing for comprehensive monitoring of seizure activity over an extended period.
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The procedure described by CPT® Code 61531 is indicated for patients who require long-term monitoring of seizure activity. This may include individuals with:
The procedure for subdural implantation of strip electrodes involves several critical steps to ensure accurate placement and functionality of the electrodes.
After the completion of the procedure, patients are typically monitored for any immediate complications, such as infection or bleeding. Recovery may involve observation in a hospital setting to ensure that the electrodes are functioning correctly and that the patient is stable. Follow-up care may include imaging studies to assess the placement of the electrodes and to monitor for any potential complications. Patients may also require additional evaluations to interpret the data collected from the electrodes during the monitoring period.
| Short Descr | IMPLANT BRAIN ELECTRODES | Medium Descr | SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING | Long Descr | Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring | 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 | 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) |
| 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. | 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 | 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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| 2010-01-01 | Changed | Code description changed. |
| 2008-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |