CPT® Code 61715

1. Indications

The procedure described by CPT® Code 61715 is indicated for the treatment of specific movement disorders that have proven resistant to standard medical therapies. The primary indications include:

• Essential Tremor A neurological condition characterized by involuntary shaking, particularly in the hands, which can significantly impact daily activities.
• Parkinson’s Disease A progressive neurodegenerative disorder that affects movement, causing tremors, stiffness, and difficulty with balance and coordination.

2. Procedure

The procedure involves several critical steps to ensure successful treatment of the targeted intracranial lesions. These steps include:

• Preparation of the Patient The patient's scalp is shaved and inspected for any scars or lesions that could interfere with the ultrasound waves. This step is crucial for ensuring optimal transmission of the ultrasound energy.
• Placement of Stereotactic Frame Four pins are inserted into the scalp to secure a stereotactic frame, which is positioned low on the head. This frame is essential for accurately centering the brain within the treatment window, allowing for precise targeting of the lesions.
• Application of Silicone Membrane A silicone membrane is placed over the scalp, which is then filled with cool, degassed water at approximately 18°C. This cooling mechanism is vital to prevent burns to the external tissues and bone during the application of ultrasound waves.
• Positioning in MRI Scanner The patient is positioned on the MRI table, and a helmet containing the ultrasound transducer is placed over the silicone membrane. The frame and transducer are secured to the MRI machine to maintain stability throughout the procedure.
• Imaging and Treatment Planning MRI sequences are obtained for the entire brain, focusing on the target areas. The images are reviewed by the surgeon, who formulates a treatment plan based on the visualized anatomy and pathology.
• Execution of Treatment A specialized software program calculates the necessary treatment parameters. The procedure commences with the generation of focused ultrasound energy from the helmet transducer, creating sonication that targets the lesions.
• Real-Time Monitoring Magnetic resonance thermometry imaging is utilized to provide real-time temperature maps during the procedure, ensuring that the lesions are being adequately treated while minimizing damage to surrounding healthy tissue.
• Completion of Procedure Upon completion of the treatment, the patient is uncoupled from the helmet and frame, and subsequently removed from the MRI scanner, concluding the procedure.

3. Post-Procedure

After the procedure, patients are typically monitored for any immediate side effects or complications. The recovery process may vary depending on individual circumstances, but patients are generally expected to resume normal activities shortly after the procedure, given its non-invasive nature. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to monitor for any potential side effects or complications that may arise post-procedure.