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The procedure described by CPT® Code 61564 involves the surgical excision of a benign tumor located in the cranial bone, which may include conditions such as fibrous dysplasia. This surgical intervention is significant as it not only addresses the tumor itself but also involves the decompression of the optic nerve, which may be affected by the tumor's presence. The excision is performed both intra- and extracranially, indicating that the surgeon will access the tumor from both inside the skull and from the outside, ensuring complete removal of the tumor while minimizing damage to surrounding structures. The optic nerve decompression is a critical component of this procedure, as it aims to relieve pressure on the optic nerve, potentially restoring or preserving vision that may be compromised due to the tumor's growth. This procedure is typically indicated when the tumor poses a risk of neurological impairment or when it causes significant symptoms related to its size or location.
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Code 61564 is indicated for the surgical excision of benign tumors of the cranial bone, particularly in cases where the tumor may be causing pressure on the optic nerve, leading to potential vision impairment or other neurological symptoms. The procedure is performed when the tumor is diagnosed and requires intervention to prevent further complications or to alleviate existing symptoms associated with the tumor's presence.
The procedure begins with the patient being placed under general anesthesia to ensure comfort and immobility during the surgery. The surgeon then makes an incision in the scalp to access the cranial bone. Following this, the surgeon carefully removes a section of the skull to expose the tumor. Once the tumor is visible, the surgeon excises the benign tumor from the cranial bone, ensuring that all tumor tissue is removed to prevent recurrence. After the tumor is excised, the surgeon assesses the optic nerve for any signs of compression. If the optic nerve is found to be compressed, the surgeon performs optic nerve decompression, which involves relieving the pressure on the nerve to restore its function. After completing the excision and decompression, the surgeon meticulously closes the incision in the skull and scalp, ensuring proper alignment and securing the bone flap in place if necessary.
After the procedure, the patient is monitored in a recovery area until the effects of anesthesia wear off. Post-operative care includes managing pain and monitoring for any complications such as infection or bleeding. The patient may require imaging studies to ensure that the tumor has been completely removed and that the optic nerve is functioning properly. Follow-up appointments are essential to assess recovery and to monitor for any signs of tumor recurrence. The expected recovery time may vary depending on the extent of the surgery and the patient's overall health, but patients are typically advised to avoid strenuous activities during the initial recovery phase.
| Short Descr | EXCISION OF SKULL TUMOR | Medium Descr | EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN | Long Descr | Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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 | 9 - Other OR therapeutic nervous system procedures |
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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 1991-01-01 | Added | First appearance in code book in 1991. |