How To Use CPT Code 61520

CPT 61520 describes the procedure for craniectomy to excise a brain tumor located in the infratentorial or posterior fossa, specifically the cerebellopontine angle. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61520?

CPT 61520 can be used to describe the surgical procedure performed to remove a brain tumor located in the cerebellopontine angle, which is below the tentorium cerebelli or in the posterior fossa. The provider removes a portion of the skull bone to gain access to the tumor and excises it. This code specifically applies to the infratentorial or posterior fossa approach for cerebellopontine angle tumor excision.

2. Official Description

The official description of CPT code 61520 is: ‘Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor.’

3. Procedure

1. The provider begins by making an incision in the scalp above the area where the tumor is located.
2. They then retract the scalp to expose the surgical site.
3. A circular portion of bone is removed by drilling a burr hole.
4. If necessary, additional burr holes may be drilled to raise a bone flap for better exposure of the tumor.
5. The provider inserts a craniotome, a surgical saw, through the burr holes to create a bone flap, which is then removed to expose the tumor.
6. The tumor is identified and excised.
7. Any excess fluid or blood is drained using a drain.
8. The layers of tissue are sutured together.
9. The bone flap is reattached using plates, wires, or sutures.
10. The scalp is reapproximated and sutured, and a sterile dressing is applied to the wound.

4. Qualifying circumstances

CPT 61520 is performed when there is a cerebellopontine angle tumor located below the tentorium cerebelli or in the posterior fossa. The procedure is typically performed by a neurosurgeon or a provider with expertise in brain tumor excision. The patient must meet the medical necessity criteria for tumor removal, and the procedure must be performed using the infratentorial or posterior fossa approach.

5. When to use CPT code 61520

CPT code 61520 should be used when a craniectomy is performed to excise a cerebellopontine angle tumor located in the infratentorial or posterior fossa. This code is specific to this particular approach and location of the tumor. It should not be used for tumors located in other areas of the brain or for different types of procedures.

6. Documentation requirements

To support a claim for CPT 61520, the provider must document the following information:

• Diagnosis of the brain tumor and the medical necessity for its excision
• Details of the surgical approach, including the infratentorial or posterior fossa location
• Description of the procedure performed, including the use of burr holes, bone flap creation, tumor excision, and closure techniques
• Any additional procedures performed, such as fluid or blood drainage
• Date of the procedure and the duration of the surgery
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 61520, ensure that the procedure meets the criteria for cerebellopontine angle tumor excision in the infratentorial or posterior fossa. Use the appropriate CPT code based on the specific location and approach of the tumor. It is important to follow the coding guidelines and any applicable modifiers to accurately report the procedure. Additionally, be aware of any specific payer requirements or policies regarding billing for this procedure.

8. Historical information

CPT 61520 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 performs a craniectomy to excise a cerebellopontine angle tumor located in the posterior fossa.
2. A patient undergoes a craniectomy for the removal of an infratentorial cerebellopontine angle tumor by a skilled neurosurgeon.
3. A provider performs a craniectomy to excise a cerebellopontine angle tumor located below the tentorium cerebelli.
4. A neurosurgeon uses the infratentorial approach to perform a craniectomy for the removal of a posterior fossa cerebellopontine angle tumor.
5. A patient with a cerebellopontine angle tumor undergoes a craniectomy in the posterior fossa by a qualified provider.
6. A skilled neurosurgeon performs a craniectomy to excise a cerebellopontine angle tumor located below the tentorium cerebelli.
7. A provider utilizes the infratentorial approach to perform a craniectomy for the removal of an infratentorial cerebellopontine angle tumor.
8. A neurosurgeon performs a craniectomy to excise a cerebellopontine angle tumor located in the posterior fossa.