How To Use CPT Code 61518

CPT 61518 describes the surgical procedure of craniectomy for the excision of a brain tumor located below the tentorium cerebelli or in the posterior fossa, excluding meningioma, cerebellopontine angle tumor, or midline tumor at the base of the skull. This article will provide an overview of CPT code 61518, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 61518?

CPT 61518 is a code used to describe a specific surgical procedure known as craniectomy. This procedure involves the removal of a portion of the skull bone to access and excise a brain tumor located below the tentorium cerebelli or in the posterior fossa. It is important to note that this code should not be used for the excision of meningioma, cerebellopontine angle tumor, or midline tumor at the base of the skull.

2. Official Description

The official description of CPT code 61518 is: ‘Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull.’

3. Procedure

1. In this surgical procedure, the healthcare provider begins by making an incision in the scalp above the area where the brain tumor is located.
2. The provider then retracts the scalp to gain access to the skull.
3. A circular portion of the skull bone is removed using a drilling tool called a burr drill, creating a burr hole.
4. Additional burr holes may be drilled to raise a bone flap, providing better exposure of the tumor.
5. The provider uses a surgical saw, known as a craniotome, to cut between the burr holes and create a bone flap, which is then removed to expose the tumor.
6. The tumor is identified and excised by the provider.
7. Any excess fluid or blood is drained using a drain.
8. The layers of tissue are sutured together, and the bone flap is reattached using plates, wires, or sutures.
9. The scalp is reapproximated and sutured, and a sterile dressing is applied to cover the wound.

4. Qualifying circumstances

CPT code 61518 is applicable when a brain tumor located below the tentorium cerebelli or in the posterior fossa needs to be excised. However, this code should not be used for the excision of meningioma, cerebellopontine angle tumor, or midline tumor at the base of the skull.

5. When to use CPT code 61518

CPT code 61518 should be used when a craniectomy procedure is performed to excise a brain tumor located below the tentorium cerebelli or in the posterior fossa, excluding meningioma, cerebellopontine angle tumor, or midline tumor at the base of the skull.

6. Documentation requirements

To support a claim for CPT code 61518, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the presence of a brain tumor below the tentorium cerebelli or in the posterior fossa
• Description of the surgical procedure performed, including the use of burr holes, bone flap creation, tumor excision, and closure techniques
• Date of the procedure
• Any additional details or complications encountered during the surgery
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 61518, it is important to ensure that the procedure performed meets the criteria specified in the code description. This includes the excision of a brain tumor below the tentorium cerebelli or in the posterior fossa, excluding specific tumor types.

It is also important to follow any additional guidelines provided by payers or coding authorities regarding the appropriate use of this code and any associated modifiers.

8. Historical information

CPT code 61518 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates or changes since its addition.

9. Examples

1. A neurosurgeon performs a craniectomy to excise a brain tumor located below the tentorium cerebelli in a patient.
2. A patient undergoes a craniectomy procedure to remove a brain tumor in the posterior fossa.
3. A healthcare provider performs a craniectomy to excise a brain tumor located below the tentorium cerebelli, excluding a meningioma.
4. A surgeon performs a craniectomy to remove a brain tumor in the posterior fossa, excluding a cerebellopontine angle tumor.
5. A patient undergoes a craniectomy procedure to excise a brain tumor located below the tentorium cerebelli, excluding a midline tumor at the base of the skull.