1 code page views remaining today. Guest accounts are limited to 2 daily page views. Register free account to get more views.
Log in Register free account

Official Description

Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 61700 involves surgical intervention on a simple intracranial aneurysm located within the carotid circulation. A simple intracranial aneurysm is defined as one that measures 15 mm or less in diameter, lacks calcification at the neck of the aneurysm, and does not incorporate normal vessels into its neck. This type of aneurysm can be effectively treated without the need for complex techniques such as temporary vessel occlusion, trapping, or cardiopulmonary bypass. The surgical approach is determined by the specific location of the aneurysm within the intracranial space, with potential access points including the interhemispheric fissure or the pterion. The procedure begins with an incision through the skin and subcutaneous tissue, followed by a craniectomy to remove the overlying bone. Once the dura mater is opened, the arachnoid membrane is carefully nicked, and cerebrospinal fluid may be drained to enhance visibility and access to the internal carotid or vertebrobasilar artery. The surgeon then identifies and isolates the artery from the surrounding arachnoid membrane, allowing for direct exposure of the aneurysm. The definitive treatment for simple aneurysms typically involves the application of a surgical clip, which serves to permanently exclude the aneurysm from the intracranial circulation, thereby reducing the risk of rupture and associated complications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 61700 is indicated for the surgical treatment of simple intracranial aneurysms located in the carotid circulation. The specific indications for this procedure include:

  • Simple Intracranial Aneurysm Aneurysms that are 15 mm or less in size, without calcification at the neck, and not incorporating normal vessels.
  • Risk of Rupture Patients with simple aneurysms who are at risk of rupture, which can lead to serious complications such as subarachnoid hemorrhage.
  • Symptomatic Aneurysms Aneurysms that may be causing symptoms due to their size or location, necessitating surgical intervention to alleviate symptoms and prevent further complications.

2. Procedure

The surgical procedure for CPT® Code 61700 involves several critical steps to ensure effective treatment of the aneurysm. The steps are as follows:

  • Step 1: Incision and Craniectomy The procedure begins with a careful incision through the skin and subcutaneous tissue over the area where the aneurysm is located. Following this, a craniectomy is performed to remove the overlying bone, providing access to the intracranial space.
  • Step 2: Opening the Dura Mater Once the bone has been removed, the dura mater, which is the protective covering of the brain, is opened to expose the underlying structures. This step is crucial for accessing the aneurysm directly.
  • Step 3: Arachnoid Membrane and Cerebrospinal Fluid Management The arachnoid membrane is then carefully nicked, and cerebrospinal fluid may be drained as necessary. This drainage helps to maximize exposure of the internal carotid or vertebrobasilar artery, facilitating the identification of the aneurysm.
  • Step 4: Identification and Isolation of the Artery The surgeon locates the artery and separates it from the surrounding arachnoid membrane. This step is essential for gaining direct access to the aneurysm itself.
  • Step 5: Aneurysm Exposure and Clipping With the artery isolated, the aneurysm is exposed. The final step involves the application of a surgical clip to the aneurysm, which permanently excludes it from the intracranial circulation, thereby reducing the risk of rupture and associated complications.

3. Post-Procedure

After the completion of the procedure, patients typically require monitoring in a recovery setting to assess for any immediate complications. Post-operative care may include managing pain, monitoring neurological status, and ensuring proper recovery from anesthesia. Patients may also need to be observed for signs of complications such as bleeding or infection. The expected recovery period can vary based on individual patient factors and the complexity of the surgery, but follow-up appointments will be necessary to evaluate the surgical site and overall recovery. Additionally, patients may receive instructions regarding activity restrictions and any necessary rehabilitation to support their recovery process.

Short Descr BRAIN ANEURYSM REPR SIMPLE
Medium Descr SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION
Long Descr Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation
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 2
CCS Clinical Classification 59 - Other OR procedures on vessels of head and neck

This is a primary code that can be used with these additional add-on codes.

61316 Addon Code MPFS Status: Active Code APC C Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure)
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)
GC This service has been performed in part by a resident under the direction of a teaching physician
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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
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)
Date
Action
Notes
2011-01-01 Changed Short description changed.
2001-01-01 Changed Code description changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
Code
Description