CPT® Code 61556

1. Indications

The procedure described by CPT® Code 61556 is indicated for the treatment of craniosynostosis, which may present with the following conditions:

• Premature Closure of Cranial Sutures - This condition leads to abnormal head shape and potential neurological impairment due to restricted brain growth.
• Increased Intracranial Pressure - The early fusion of sutures can cause pressure on the brain, necessitating surgical intervention to alleviate this pressure.
• Associated Syndromes - Craniosynostosis may occur as part of syndromic conditions such as Crouzon, Apert, Carpenter, Chotzen, or Pfeiffer syndrome, which may require surgical correction to address both cranial and associated abnormalities.

2. Procedure

The surgical procedure for CPT® Code 61556 involves several critical steps to effectively treat craniosynostosis:

• Step 1: Skin Incision - A skin incision is made over the frontal or parietal bone, allowing access to the underlying structures. This incision is carefully planned to minimize scarring and facilitate healing.
• Step 2: Scalp Flap Elevation - Following the incision, a scalp flap is elevated to expose the skull. This step is crucial for providing the necessary visibility and access to the cranial bones.
• Step 3: Skull Exposure and Bone Marking - The skull is then exposed, and the surgeon marks the areas where bone cuts will be made. This careful planning is essential to ensure that the bone flap can be properly shaped and repositioned.
• Step 4: Drilling Burr Holes - Burr holes are drilled along the lines of the planned bone cuts. These holes serve as entry points for the subsequent bone cuts and help to facilitate the removal of the bone flap.
• Step 5: Making Bone Cuts - Using a craniotome or saw, the surgeon makes bone cuts to connect the burr holes. This step is critical for creating a bone flap that can be elevated and repositioned.
• Step 6: Elevating the Bone Flap - The bone flap is carefully elevated, allowing the surgeon to access the underlying brain tissue and assess the need for any additional interventions.
• Step 7: Repositioning the Bone - The bone is repositioned as necessary to accommodate normal brain growth and to allow for the remodeling of the skull. This step is vital for ensuring that the skull can develop appropriately post-surgery.
• Step 8: Securing the Bone Flap - The bone flap is secured in place using miniplates and screws as needed, ensuring stability and proper alignment during the healing process.
• Step 9: Closing Incisions - Finally, the incisions are closed in layers to promote optimal healing and minimize complications.
• Step 10: Post-Operative Care - After the procedure, the infant is placed in a custom-made helmet designed to help reshape the skull as bone growth occurs, supporting the recovery process.

3. Post-Procedure

Post-procedure care following a craniotomy for craniosynostosis involves monitoring the infant for any signs of complications, such as infection or increased intracranial pressure. The infant will typically be placed in a custom-made helmet to assist in reshaping the skull as it heals and grows. Follow-up appointments are essential to assess the healing process and ensure that the skull is developing normally. Parents or caregivers will receive specific instructions regarding care at home, including how to manage the surgical site and recognize any concerning symptoms that may require immediate medical attention.