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The CPT® Code 61540 refers to a surgical procedure known as craniotomy with elevation of the bone flap, specifically performed for lobectomy of the brain, excluding the temporal lobe. This procedure involves the partial or total removal of a lobe of the brain and is conducted without the use of electrocorticography during the surgery. Electrocorticography, also known as brain mapping, is a technique that records electrical activity from the cerebral cortex to help delineate the boundaries of the area responsible for epileptic seizures. In this case, the absence of electrocorticography indicates that the surgeon relies on anatomical landmarks and preoperative imaging rather than real-time brain activity monitoring to guide the resection. The procedure begins with an incision in the scalp, followed by the creation of scalp flaps and burr holes in the skull. The bone flap is then elevated to access the underlying brain tissue. The dura mater, a protective membrane covering the brain, is opened to allow for the surgical intervention. The surgical steps involve careful dissection and removal of brain tissue, including critical structures such as the hippocampus and amygdala, while preserving vital blood vessels and surrounding tissues. The procedure concludes with the repair of the dura, replacement of the bone flap, and closure of the scalp layers. This code is essential for accurately documenting and billing for the surgical intervention performed without the aid of electrocorticography.
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The procedure associated with CPT® Code 61540 is indicated for various neurological conditions that necessitate the removal of brain tissue to alleviate symptoms or control seizures. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 61540 involves several critical steps to ensure successful lobectomy. The following outlines the procedural steps:
Post-procedure care following a lobectomy performed under CPT® Code 61540 includes monitoring for complications such as infection, bleeding, or neurological deficits. Patients are typically observed in a recovery area before being transferred to a hospital room for further monitoring. Pain management is provided, and neurological assessments are conducted regularly to evaluate the patient's recovery. Rehabilitation services may be initiated to support recovery and address any deficits resulting from the surgery. Follow-up appointments are essential to assess the surgical site, monitor healing, and evaluate the effectiveness of the procedure in controlling seizures or alleviating symptoms. The overall recovery time may vary based on the individual patient's health status and the extent of the surgery performed.
| Short Descr | REMOVAL OF BRAIN TISSUE | Medium Descr | CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG | Long Descr | Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, 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. | 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. | 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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| 2004-01-01 | Added | First appearance in code book in 2004. |