How To Use CPT Code 61539

CPT 61539 describes a specific procedure involving the removal of a brain lobe, other than the temporal lobe, through an elevated portion of the skull bone, along with the use of intraoperative electrocorticography (ECoG) to record brain activity during the surgery. 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 61539?

CPT 61539 is a code used to describe a surgical procedure in which a brain lobe, other than the temporal lobe, is partially or totally removed through an elevated portion of the skull bone. This procedure also involves the use of intraoperative electrocorticography (ECoG) to record the electrical activity in the brain and identify the site of seizures. It is typically performed to define the area in the brain where epileptic seizures originate.

2. Official Description

The official description of CPT code 61539 is: ‘Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery.’

3. Procedure

1. The procedure begins with the provider making an incision in the scalp and creating burr holes to elevate a portion of the skull bone.
2. Next, the provider retracts the brain membranes to access the affected lobe of the brain.
3. Electrodes are then placed on the surface of the brain, either on the first layer of membrane or into deep areas of the brain using thin wires.
4. The electrodes are connected to continuous electroencephalogram (EEG) equipment to record and map the brain activity.
5. The provider moves the electrodes as necessary to gather data and define the extent of the brain causing the seizures.
6. Once the desired information is obtained, the provider partially or totally removes the lobe.
7. Excess fluid or blood is drained, and the provider performs electrocorticography (ECoG) again to check for any residual epileptic activity.
8. The provider then sutures the layers of membranes, reattaches the bone flap using plates, wires, or sutures, and covers the wound with a sterile dressing.

4. Qualifying circumstances

CPT 61539 is performed on patients who require the removal of a brain lobe, other than the temporal lobe, for the management of epileptic seizures. The procedure is typically performed by a qualified healthcare professional who has the necessary expertise in neurosurgery. The use of electrocorticography (ECoG) during the surgery is an essential component of this procedure.

5. When to use CPT code 61539

CPT code 61539 should be used when a craniotomy is performed to remove a brain lobe, other than the temporal lobe, and intraoperative electrocorticography (ECoG) is utilized during the surgery. This code is specific to lobectomy procedures and should not be used for other types of brain surgeries.

6. Documentation requirements

To support a claim for CPT 61539, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for lobectomy
• Details of the procedure, including the specific brain lobe removed and the use of electrocorticography (ECoG)
• Date of the surgery and the duration of the procedure
• Any complications or unexpected findings during the surgery
• Post-operative care instructions and follow-up plans
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 61539, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the use of electrocorticography (ECoG) during the surgery. Additionally, be aware of any specific billing guidelines or requirements set forth by insurance providers or government payers.

8. Historical information

CPT 61539 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A neurosurgeon performing a craniotomy with elevation of bone flap to remove a frontal lobe brain lesion, utilizing electrocorticography (ECoG) during the surgery.
2. A patient undergoing a craniotomy with elevation of bone flap for the partial lobectomy of the parietal lobe, with intraoperative electrocorticography (ECoG) to identify the site of seizures.
3. A neurosurgeon performing a craniotomy with elevation of bone flap to remove an occipital lobe brain lesion, utilizing electrocorticography (ECoG) during the surgery.
4. A patient undergoing a craniotomy with elevation of bone flap for the total lobectomy of the frontal lobe, with intraoperative electrocorticography (ECoG) to pinpoint the origin of seizures.
5. A neurosurgeon performing a craniotomy with elevation of bone flap to remove a parietal lobe brain lesion, utilizing electrocorticography (ECoG) during the surgery.
6. A patient undergoing a craniotomy with elevation of bone flap for the partial lobectomy of the occipital lobe, with intraoperative electrocorticography (ECoG) to map the brain activity.