How To Use CPT Code 61500

CPT 61500 describes the procedure of craniectomy, which involves the removal of a small portion of the skull bone to excise a tumor or other abnormal growth. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61500?

CPT 61500 is used to describe the surgical procedure of craniectomy, where a qualified healthcare provider removes a small portion of the skull bone to excise a tumor or other abnormal growth. This code is specifically used when the procedure involves the removal of bone from the skull.

2. Official Description

The official description of CPT code 61500 is: ‘Craniectomy; with excision of tumor or other bone lesion of skull.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. An incision is made in the scalp to expose the area of the skull affected by the tumor or bone lesion.
3. The provider folds back the tissue to fully expose the bone.
4. The portion of the skull impacted by the tumor or lesion is carefully removed.
5. If the removed bone cannot be used for reconstruction, the provider may utilize an autologous split calvarial bone graft, bone from the posterior wall of the sinus or iliac crest, or a plastic replacement.
6. The bone flap is replaced, or the graft or plastic replacement is secured in place.
7. The tissue flap is folded back, and the scalp is closed with sutures or staples.
8. A sterile dressing is applied to the surgical site.

4. Qualifying circumstances

CPT 61500 is performed when a patient requires the removal of a tumor or other bone lesion from the skull. The procedure is typically performed by a qualified healthcare provider who has the necessary expertise in craniectomy. The patient must have a documented diagnosis of a tumor or bone lesion that necessitates surgical intervention.

5. When to use CPT code 61500

CPT code 61500 should be used when a qualified healthcare provider performs a craniectomy procedure with the specific purpose of excising a tumor or other bone lesion from the skull. It is important to ensure that the procedure performed aligns with the description provided by CPT code 61500.

6. Documentation requirements

To support a claim for CPT 61500, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the presence of a tumor or bone lesion
• Details of the procedure performed, including the specific location of the tumor or lesion
• Any additional procedures or techniques used, such as bone grafting or plastic replacement
• Date of the procedure
• Start and end time of the procedure
• Any complications or unexpected findings during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 61500, it is important to ensure that the procedure performed aligns with the description provided by the code. The healthcare provider should also follow any specific billing guidelines provided by the payer or insurance company. It is important to review the documentation requirements and ensure that all necessary information is included in the claim.

8. Historical information

CPT 61500 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone changes over the years, including being added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A neurosurgeon performing a craniectomy to remove a tumor from the skull of a patient.
2. A maxillofacial surgeon excising a bone lesion from the skull using a craniectomy procedure.
3. A pediatric neurosurgeon performing a craniectomy to remove a tumor in the skull of a child.
4. An oncology surgeon excising a tumor from the skull using a craniectomy procedure.
5. A craniofacial surgeon performing a craniectomy to remove a bone lesion from the skull of a patient.
6. A neurosurgeon performing a craniectomy to excise a tumor from the skull of a patient with a brain tumor.
7. A plastic surgeon excising a bone lesion from the skull using a craniectomy procedure.
8. A neurosurgeon performing a craniectomy to remove a tumor from the skull of a patient with a brain tumor.
9. An orthopedic surgeon excising a bone lesion from the skull using a craniectomy procedure.
10. A neurosurgeon performing a craniectomy to remove a tumor from the skull of a patient with a brain tumor.