How To Use CPT Code 61333

CPT 61333 describes the exploration of the orbit with the removal of a lesion using a transcranial approach. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61333?

CPT 61333 can be used to describe the surgical procedure of exploring the orbit and removing a lesion or tumor using a transcranial approach. This code is used when the provider makes an incision in the scalp, accesses the eye, and carefully removes the lesion while preserving the surrounding structures.

2. Official Description

The official description of CPT code 61333 is: ‘Exploration of orbit (transcranial approach), with removal of lesion.’

3. Procedure

1. The provider begins by making a bicoronal incision behind the ear within the hairline and extending it to the opposite side.
2. They carefully fold back the tissue flap to expose the bone, ensuring the preservation of the pericranium.
3. An orbitofrontal bone flap is created by freeing the thin part of the roof of the orbit behind the orbital rim.
4. The provider raises and retracts the frontal lobe of the brain to gain access to the orbital cavity.
5. They explore the orbital cavity and identify the lesion, then proceed to dissect it from the surrounding structures while controlling bleeding.
6. After the procedure, the provider closes the orbital area, replaces the bone and tissue flap, and sutures or staples the area closed. A secure dressing is applied to the eye.

4. Qualifying circumstances

CPT 61333 is performed on patients who require exploration of the orbit and removal of a lesion or tumor. This procedure is typically done when other treatment options have been exhausted or when the lesion poses a significant risk to the patient’s health. The provider must use a transcranial approach to access the orbit and perform the necessary surgical steps.

5. When to use CPT code 61333

CPT code 61333 should be used when a provider performs the exploration of the orbit and removal of a lesion using a transcranial approach. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If a different approach or technique is used, a different CPT code may be more appropriate.

6. Documentation requirements

To support a claim for CPT 61333, the provider must document the following information:

• Patient’s diagnosis and the need for exploration of the orbit and lesion removal
• Details of the surgical procedure, including the specific steps taken and any complications encountered
• Date of the procedure and the duration of the surgery
• Any additional procedures or interventions performed during the same surgical session
• Any post-operative care provided to the patient
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 61333, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the procedure and provide any necessary supporting documentation. Additionally, be aware of any specific billing guidelines or requirements set forth by insurance payers or regulatory bodies.

8. Historical information

CPT 61333 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A neurosurgeon performing the exploration of the orbit and removal of a tumor using a transcranial approach.
2. An ophthalmologist conducting the exploration of the orbit and removal of a lesion to improve the patient’s vision.
3. A maxillofacial surgeon performing the exploration of the orbit and removal of a tumor to alleviate facial pain and restore facial symmetry.
4. A craniofacial surgeon conducting the exploration of the orbit and removal of a lesion to treat a congenital abnormality.
5. A neurologist performing the exploration of the orbit and removal of a tumor to prevent further neurological complications.
6. A plastic surgeon conducting the exploration of the orbit and removal of a lesion to improve the patient’s appearance and self-confidence.
7. An otolaryngologist performing the exploration of the orbit and removal of a tumor to treat a sinonasal malignancy.
8. A head and neck surgeon conducting the exploration of the orbit and removal of a lesion to treat a metastatic tumor.
9. A pediatric surgeon performing the exploration of the orbit and removal of a tumor to improve the child’s quality of life.
10. A radiation oncologist conducting the exploration of the orbit and removal of a lesion to prepare for radiation therapy.