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The procedure described by CPT® Code 61586 involves a bicoronal, transzygomatic, and/or LeFort I osteotomy approach to the anterior cranial fossa. This surgical technique is utilized to access lesions or defects located at the front of the skull, specifically within the anterior cranial fossa, which is the area of the skull that houses the frontal lobes of the brain. The approach is performed through the facial region, allowing the surgeon to reach the targeted area effectively. During the procedure, the physician may remove the zygomatic bone, commonly known as the cheekbone, and potentially a section of bone adjacent to it that includes parts of the nasal structure. This access is crucial for addressing various conditions that may affect the anterior cranial fossa. Additionally, the procedure may involve the use of internal fixation devices such as pins and screws to stabilize the reconstructed facial structures, although it is noted that no bone graft is utilized in this specific approach. The careful planning and execution of this procedure are essential for ensuring optimal outcomes in the management of cranial and facial defects.
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The bicoronal, transzygomatic, and/or LeFort I osteotomy approach to the anterior cranial fossa is indicated for various conditions that necessitate access to the front of the skull. The following are explicitly provided indications for this procedure:
The procedure involves several critical steps to ensure effective access and treatment of the targeted area. Each step is detailed as follows:
After the procedure, the patient is monitored for any immediate complications and provided with post-operative care instructions. Expected recovery may involve managing pain and swelling, which can be addressed with prescribed medications. Follow-up appointments are essential to assess healing and ensure that the surgical site is recovering as expected. Patients may also receive guidance on activity restrictions and care for the surgical site to prevent infection and promote healing. The overall recovery timeline can vary based on individual factors and the extent of the procedure performed.
| Short Descr | RESECT NASOPHARYNX SKULL | Medium Descr | BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT | Long Descr | Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft | 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) | 2 - Team surgeons permitted; pay by report. | 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). | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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). | 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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| 2011-01-01 | Changed | Short description changed. |
| 1997-01-01 | Added | First appearance in code book in 1997. |
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