How To Use CPT Code 61552

CPT 61552 describes the procedure for craniectomy for craniosynostosis, specifically addressing multiple cranial sutures. 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 61552?

CPT 61552 can be used to describe the surgical procedure performed to treat craniosynostosis, a condition where the cranial sutures fuse prematurely in young children. This code specifically applies to cases where multiple cranial sutures need to be addressed. The provider makes an incision into the skull bone over the affected sutures, reshapes the skull bone, and sutures the scalp layers together to allow normal growth of the skull.

2. Official Description

The official description of CPT code 61552 is: ‘Craniectomy for craniosynostosis; multiple cranial sutures.’ This code is used when the provider performs a craniectomy procedure to treat craniosynostosis, specifically addressing multiple cranial sutures. It is important to note that this code does not apply to cases involving cranial reconstruction for orbital hypertelorism or general reconstruction.

3. Procedure

1. When performing craniectomy for craniosynostosis, the provider begins by making an incision into the skull bone over the affected cranial sutures.
2. Once the incision is made, the provider reshapes the skull bone to an anatomically appropriate position.
3. After reshaping the skull, the provider sutures the scalp layers together to close the incision.
4. Finally, a sterile dressing is applied to cover the wound.

4. Qualifying circumstances

CPT 61552 is applicable in cases where the patient has craniosynostosis, a congenital condition characterized by the premature fusion of cranial sutures in young children. The procedure is performed by a provider to address multiple cranial sutures. It is important to note that this code is not used for cases involving cranial reconstruction for orbital hypertelorism or general reconstruction.

5. When to use CPT code 61552

CPT code 61552 should be used when the provider performs a craniectomy procedure to treat craniosynostosis, specifically addressing multiple cranial sutures. It is important to ensure that the procedure performed aligns with the official description of the code. If the procedure involves the treatment of a single cranial suture, a different code, such as CPT 61550, should be used instead.

6. Documentation requirements

To support a claim for CPT 61552, the provider must document the following information:

• Patient’s diagnosis of craniosynostosis
• Details of the procedure performed, including the specific cranial sutures addressed
• Date of the procedure
• Incision site and closure method
• Any additional relevant information or complications
• Provider’s signature

7. Billing guidelines

When billing for CPT 61552, it is important to ensure that the procedure performed aligns with the official description of the code. The provider should also follow any specific billing guidelines provided by the payer. It is important to note that CPT 61552 should not be reported with codes 21260-21263 (for cranial reconstruction for orbital hypertelorism) or codes 21172-21180 (for general reconstruction).

8. Historical information

CPT 61552 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 provider performs a craniectomy procedure to treat craniosynostosis, addressing multiple cranial sutures in a young child.
2. During the procedure, the provider makes an incision into the skull bone over the affected sutures, reshapes the skull bone, and sutures the scalp layers together.
3. The craniectomy allows for normal growth of the skull and improves the patient’s condition.
4. Another provider performs a similar craniectomy procedure for craniosynostosis, addressing multiple cranial sutures in a different patient.
5. The procedure is successful in correcting the premature fusion of the cranial sutures and promoting proper skull growth.
6. In both cases, CPT code 61552 is used to accurately report the performed procedure.
7. It is important to note that each case may have unique details and considerations, but the use of CPT code 61552 remains consistent.
8. These examples highlight the appropriate usage of CPT code 61552 in cases of craniectomy for craniosynostosis, specifically addressing multiple cranial sutures.
9. Providers should ensure that the procedure performed aligns with the official description of the code and accurately document the details for proper billing and reimbursement.
10. By using CPT code 61552, providers can accurately report and document the craniectomy procedure for craniosynostosis, addressing multiple cranial sutures.