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The CPT® Code 61735 refers to the creation of a lesion using a stereotactic method, which involves precise localization and recording techniques, and may be performed in single or multiple stages. This procedure specifically targets subcortical structures of the brain, excluding the globus pallidus and thalamus. Subcortical structures are located beneath the cerebral cortex and include various components of the brain such as the limbic system, hypothalamus, midbrain, and hindbrain. The globus pallidus and thalamus, which are part of the basal ganglia, are not included in this procedure's scope. The creation of lesions in these subcortical areas is often part of psychosurgical interventions aimed at treating certain neurological or psychiatric conditions. The procedure is considered investigational or experimental by many insurance payers, which may affect coverage and reimbursement. During the procedure, a specialized frame is affixed to the patient's skull to ensure accuracy, and imaging techniques such as MRI or CT scans are utilized to map the brain and identify the precise location for lesion creation. This meticulous approach is essential for minimizing risks and maximizing the potential therapeutic benefits of the surgery.
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The procedure described by CPT® Code 61735 is indicated for various neurological or psychiatric conditions that may benefit from the creation of lesions in subcortical structures of the brain. These indications may include, but are not limited to, the following:
The procedure for CPT® Code 61735 involves several critical steps to ensure accurate lesion creation in the targeted subcortical structures. The following outlines the procedural steps:
After the completion of the procedure, patients are typically monitored for any immediate complications or adverse effects. Post-operative care may include pain management and observation for neurological function. Recovery time can vary depending on the individual and the extent of the procedure performed. Patients may require follow-up appointments to assess the effectiveness of the lesion and to monitor for any potential side effects. It is essential to provide comprehensive post-operative instructions to ensure proper healing and to address any concerns that may arise during the recovery period.
| Short Descr | INCISE SKULL/BRAIN SURGERY | Medium Descr | CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN | Long Descr | Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 | 1 - Incision and excision of CNS |
| 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 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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| Pre-1990 | Added | Code added. |
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