How To Use CPT Code 61537

CPT 61537 describes the procedure of craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery. This article will provide an overview of CPT 61537, including its official description, the detailed procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61537?

CPT 61537 is used to describe a specific surgical procedure known as craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery. This procedure involves the removal of the temporal lobe of the brain through an elevated portion of the skull bone. It is typically performed when testing indicates that epileptic seizures originate in the temporal lobe.

2. Official Description

The official description of CPT code 61537 is: ‘Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery.’

3. Procedure

1. During the procedure, the healthcare provider makes an incision in the scalp and creates burr holes to elevate a portion of the skull bone, exposing the dura.
2. The provider then opens and retracts the brain membranes to access the temporal lobe of the brain.
3. Measurements are taken to determine where to incise the cerebral cortex, and the provider dissects deep into the cortex to identify the temporal horn and hippocampus of the ventricles.
4. The provider incises and opens the pia, the innermost membrane, and removes the temporal lobe.
5. Delicate dissection and coagulation of surrounding arteries and structures are performed to ensure hemostasis.
6. Any excess fluid or blood is drained using a drain, and the layers of membranes are sutured.
7. The bone flap is then reattached using plates, wires, or sutures, and the layers of tissue are sutured together.
8. Finally, the wound is covered with a sterile dressing.

4. Qualifying circumstances

CPT 61537 is performed when testing indicates that epileptic seizures originate in the temporal lobe. It is important to note that this procedure does not involve the use of electrocorticography, which is the recording of the electrical activity of the brain by placing electrodes directly on the cerebral cortex.

5. When to use CPT code 61537

CPT code 61537 should be used when performing a craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery. It is important to accurately document the procedure and ensure that it meets the specific criteria outlined in the code description.

6. Documentation requirements

Documentation for CPT code 61537 should include:

• Confirmation of the need for the procedure based on testing indicating epileptic seizures originating in the temporal lobe
• Details of the surgical approach, including the creation of burr holes and elevation of the bone flap
• Identification of the specific structures accessed and manipulated during the procedure
• Description of the removal of the temporal lobe and any additional steps taken to ensure hemostasis
• Documentation of the closure of the layers of membranes and reattachment of the bone flap
• Confirmation of the use of a sterile dressing to cover the wound

7. Billing guidelines

When billing for CPT code 61537, it is important to ensure that the procedure performed aligns with the specific criteria outlined in the code description. It should be reported without the use of electrocorticography during surgery. It is also important to follow any additional guidelines provided by payers or coding authorities.

8. Historical information

CPT code 61537 was added to the Current Procedural Terminology system on January 1, 2004. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes a craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery, to treat their epilepsy.
2. A healthcare provider performs a craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery, on a patient with recurrent seizures originating in the temporal lobe.
3. During a surgical procedure, a surgeon removes the temporal lobe through an elevated portion of the skull bone, without the use of electrocorticography, to address the patient’s epilepsy.
4. A neurosurgeon performs a craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery, to alleviate the patient’s epileptic seizures.
5. A patient with epilepsy undergoes a craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery, to improve their quality of life.
6. A healthcare provider performs a craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery, on a patient with intractable seizures originating in the temporal lobe.
7. During a surgical procedure, a surgeon removes the temporal lobe through an elevated portion of the skull bone, without the use of electrocorticography, to address the patient’s epilepsy.
8. A neurosurgeon performs a craniotomy with elevation of bone flap for lobectomy of the temporal lobe, without electrocorticography during surgery, to alleviate the patient’s epileptic seizures.