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The procedure described by CPT® Code 61534 refers to a craniotomy performed specifically for the excision of an epileptogenic focus, which is a localized area in the brain that generates epileptic seizures. This procedure is indicated for patients diagnosed with epilepsy where a specific lesion can be identified as the source of seizures. Prior to the surgery, diagnostic imaging techniques such as electroencephalography (EEG) and magnetic resonance imaging (MRI) are utilized to locate and confirm the presence of the epileptogenic focus. In cases where the lesion is situated outside of eloquent brain regions—areas responsible for critical functions such as movement, speech, and sensory processing—the surgery can proceed without the need for intraoperative electrocorticography, a technique that monitors brain activity during the procedure. The surgical process involves making an incision in the scalp, creating flaps, and using burr holes to access the skull. The bone is then cut and elevated to expose the dura mater, which is subsequently opened to allow access to the brain tissue. The abnormal tissue is carefully excised, and once the excision is complete, the dura is closed, the bone flap is replaced, and the scalp is sutured back in layers. This procedure aims to alleviate seizure activity by removing the source of the seizures, thereby improving the patient's quality of life.
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The procedure described by CPT® Code 61534 is indicated for patients with epilepsy who have a clearly identifiable lesional or localized epileptogenic focus. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 61534 involves several critical steps to ensure the successful excision of the epileptogenic focus:
Post-procedure care following a craniotomy for the excision of an epileptogenic focus includes monitoring the patient for any signs of complications such as infection, bleeding, or neurological deficits. Patients may require pain management and will be observed in a recovery area before being transferred to a hospital room. Rehabilitation may be necessary to support recovery, and follow-up appointments will be scheduled to assess the surgical outcome and manage any ongoing seizure activity. The expected recovery time can vary based on individual patient factors and the extent of the surgery performed.
Short Descr | REMOVAL OF BRAIN LESION | Medium Descr | CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY | Long Descr | Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery | 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 | 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) |
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. | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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Pre-1990 | Added | Code added. |