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The CPT® Code 61596 refers to a surgical procedure known as the transcochlear approach to the posterior cranial fossa, jugular foramen, or midline skull base. This complex procedure includes a labyrinthectomy, which is the surgical removal of the inner ear's labyrinth structure, and decompression of critical neurovascular structures. The procedure may involve the mobilization of the facial nerve and/or the petrous carotid artery, which are essential components in the surgical management of conditions affecting the cranial base and surrounding areas. The transcochlear approach is particularly indicated for addressing lesions or abnormalities located in the posterior cranial fossa, which is the area of the skull that houses vital structures such as the brainstem and cranial nerves. This approach allows for direct access to these structures while minimizing damage to surrounding tissues. The detailed steps involved in this procedure require a high level of surgical expertise and precision, as they involve intricate dissection and manipulation of delicate anatomical structures.
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The transcochlear approach, as described by CPT® Code 61596, is indicated for various conditions affecting the posterior cranial fossa, jugular foramen, or midline skull base. The following are specific indications for this procedure:
The transcochlear approach involves several critical procedural steps, each designed to ensure safe and effective access to the targeted anatomical areas. The following outlines the detailed steps of the procedure:
Post-procedure care following the transcochlear approach involves monitoring for complications and ensuring proper recovery. Patients may require close observation for signs of neurological deficits, infection, or other postoperative complications. Pain management and wound care are essential components of post-operative care. The expected recovery period may vary based on the extent of the procedure and the patient's overall health. Follow-up appointments are crucial for assessing healing and addressing any ongoing symptoms or concerns related to the surgery.
| Short Descr | TRANSCOCHLEAR APPROACH/SKULL | Medium Descr | TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART | Long Descr | Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery | 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) | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 1994-01-01 | Added | First appearance in code book in 1994. |
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