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A craniopharyngioma is a type of benign tumor that typically contains both cystic (fluid-filled) and solid components. This tumor originates from the remnants of the craniopharyngeal duct, which is located near the base of the pituitary gland. The procedure associated with CPT® Code 61545 involves a craniotomy, which is a surgical operation where a section of the skull is removed to access the brain. In this specific case, the craniotomy is performed to excise the craniopharyngioma. The surgical approach begins with an incision made in the skin above the eyebrows, allowing access to the tumor through a supraorbital craniotomy. This method involves creating scalp flaps and drilling burr holes in the supraorbital region. The bone between these burr holes is then cut using a saw or craniotome, and a bone flap is elevated to expose the underlying dura mater, which is subsequently opened and retracted. Careful dissection of the brain tissue is performed to expose the tumor while preserving critical surrounding structures. The tumor is meticulously dissected from the surrounding tissue and excised. An intraoperative evaluation by a pathologist is conducted to assess the margins of the excised tissue. If the margins are found to contain abnormal tissue, further excision is performed, provided that critical structures can be spared. The excision process continues until the margins are clear or until the neurosurgeon determines that the maximum safe amount of tumor has been removed. After the tumor removal, the dura is closed, the bone flap is replaced and secured using sutures, wires, or miniplates and screws, and finally, the overlying muscle and skin are repaired and closed in layers.
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The procedure associated with CPT® Code 61545 is indicated for the excision of craniopharyngiomas, which are benign tumors that can cause various symptoms due to their location near the pituitary gland. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 61545 involves several critical steps to ensure the safe and effective excision of the craniopharyngioma:
Post-procedure care following a craniotomy for the excision of a craniopharyngioma includes monitoring for any complications such as infection, bleeding, or neurological deficits. Patients may require pain management and close observation in a recovery unit. Follow-up imaging studies may be necessary to assess for any residual tumor or complications. The recovery process can vary, and patients may need rehabilitation services depending on the extent of the surgery and any neurological impact. It is essential for healthcare providers to provide detailed discharge instructions and schedule follow-up appointments to ensure proper recovery and management of any ongoing symptoms.
| Short Descr | EXCISION OF BRAIN TUMOR | Medium Descr | CRANIOTOMY EXCISION CRANIOPHARYNGIOMA | Long Descr | Craniotomy with elevation of bone flap; for excision of craniopharyngioma | 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) |
| 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. | 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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