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The procedure described by CPT® Code 61543 involves a craniotomy with elevation of a bone flap for a partial or subtotal (functional) hemispherectomy. This surgical intervention is performed on the brain, which is anatomically divided into two cerebral hemispheres: the right and left. Each hemisphere consists of an outer layer known as the cerebral cortex, which is primarily composed of grey matter, and an inner layer of white matter. The two hemispheres are interconnected by a structure called the corpus callosum, which facilitates communication between them. In a functional hemispherectomy, a portion of the affected hemisphere is surgically removed, and the remaining nerve fibers, including those of the corpus callosum, are transected. This procedure is typically indicated for patients with severe epilepsy or other neurological conditions that affect one hemisphere of the brain. The deeper structures of the brain, such as the basal ganglia, thalamus, and brain stem, remain intact during this operation. The surgical approach involves making a long incision in the scalp, creating a scalp flap, and drilling burr holes to access the skull. The bone flap is then elevated to allow for the necessary surgical manipulation of the brain tissue. This complex procedure requires careful dissection and the use of specialized instruments to ensure the precise removal of the affected brain tissue while preserving critical structures.
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The procedure described by CPT® Code 61543 is indicated for specific neurological conditions that necessitate the removal of a portion of the cerebral hemisphere. The following are the primary indications for performing a partial or subtotal (functional) hemispherectomy:
The procedure for CPT® Code 61543 involves several critical steps to ensure the successful execution of a partial or subtotal (functional) hemispherectomy. The following outlines the procedural steps:
Post-procedure care following a partial or subtotal (functional) hemispherectomy involves monitoring the patient for any complications and ensuring proper recovery. Patients may require intensive care initially to manage pain and monitor neurological status. Rehabilitation services, including physical, occupational, and speech therapy, may be necessary to aid in recovery and adaptation to changes in function. Follow-up appointments are essential to assess the surgical outcome, manage any ongoing symptoms, and adjust treatment plans as needed. The expected recovery period can vary based on individual patient factors and the extent of the surgery performed.
| Short Descr | REMOVAL OF BRAIN TISSUE | Medium Descr | CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY | Long Descr | Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy | 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) |
| 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. | 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 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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