How To Use CPT Code 61105

CPT 61105 describes the procedure of creating a twist drill hole in the skull for subdural or ventricular puncture. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61105?

CPT 61105 can be used to describe the procedure in which a healthcare provider uses a hand-operated twist drill to create a hole in the skull. This hole is made to withdraw fluid from the area below the dura or from the ventricles of the brain. It is typically performed to reduce pressure on the brain or to remove fluid for testing purposes.

2. Official Description

The official description of CPT code 61105 is: ‘Twist drill hole for subdural or ventricular puncture.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. A small incision is made in the scalp, and the provider moves the scalp away to expose the skull.
3. Using a manual twist drill, the provider cranks or twists the drill by hand to create a hole in the skull.
4. The dura mater, the outermost layer of the protective layers surrounding the brain and spinal cord, is exposed through the hole.
5. The provider may use the hole to withdraw cerebrospinal fluid (CSF) to reduce pressure on the brain or to remove fluid from the subdural level of the brain or ventricles for testing.
6. Additional surgical interventions may be performed through the hole if necessary.

4. Qualifying circumstances

CPT 61105 is performed when a twist drill hole is needed for subdural or ventricular puncture. This procedure is typically done to withdraw fluid from the area below the dura or from the ventricles of the brain. It may be necessary in cases of hematoma (collection of blood on the surface of the brain), subdural conditions, or when fluid needs to be tested. The procedure should be performed by a qualified healthcare provider.

5. When to use CPT code 61105

CPT code 61105 should be used when a healthcare provider performs a twist drill hole for subdural or ventricular puncture. It is appropriate when the procedure is necessary to withdraw fluid or perform other surgical interventions. This code should be used specifically for the creation of the twist drill hole.

6. Documentation requirements

To support a claim for CPT 61105, the healthcare provider must document the following information:

• Reason for the procedure, such as hematoma, subdural condition, or fluid testing
• Date and time of the procedure
• Details of the procedure, including the use of a twist drill and the location of the hole
• Any additional surgical interventions performed through the hole
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 61105, ensure that the procedure involves the creation of a twist drill hole for subdural or ventricular puncture. It is important to follow the specific documentation requirements and guidelines for accurate billing. Report additional codes, such as 61107 for implantation of monitoring devices or 61108 for drainage of subdural hematoma, if applicable. Be aware of any Medicare changes or specific billing requirements for this procedure.

8. Historical information

CPT 61105 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition. However, it was added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A neurosurgeon performing a twist drill hole to withdraw cerebrospinal fluid from a patient with a subdural hematoma.
2. A neurologist creating a twist drill hole to remove fluid from the ventricles of a patient’s brain for testing purposes.
3. A trauma surgeon performing a twist drill hole to reduce pressure on the brain of a patient with a traumatic brain injury.
4. A neurosurgeon using a twist drill hole to perform additional surgical interventions in a patient with a subdural condition.
5. A neurologist creating a twist drill hole to monitor intracranial pressure in a patient with a suspected brain tumor.
6. A neurosurgeon performing a twist drill hole to drain fluid from the subdural level of the brain in a patient with hydrocephalus.
7. A neurologist using a twist drill hole to administer medication directly into the ventricles of a patient with an infection.
8. A trauma surgeon creating a twist drill hole to relieve pressure on the brain caused by a severe head injury.
9. A neurosurgeon performing a twist drill hole to remove fluid from the ventricles of a patient with suspected meningitis.
10. A neurologist using a twist drill hole to monitor cerebrospinal fluid pressure in a patient with suspected intracranial hypertension.