How To Use CPT Code 61556

CPT 61556 describes the procedure of craniotomy for craniosynostosis, specifically involving the frontal or parietal bone flap. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61556?

CPT 61556 can be used to describe a specific craniotomy procedure performed to treat craniosynostosis, a condition where the cranial sutures fuse prematurely in young children. In this procedure, the provider makes an incision in the skull to remove a frontal or parietal bone flap. The goal is to remodel the skull to its anatomically appropriate shape, allowing normal growth.

2. Official Description

The official description of CPT code 61556 is: ‘Craniotomy for craniosynostosis; frontal or parietal bone flap.’ This code specifically refers to the removal of a frontal or parietal bone flap during a craniotomy procedure to treat craniosynostosis.

3. Procedure

1. When performing CPT 61556, the provider begins by making an incision into the skull bone.
2. The incision is made to remove a frontal or parietal bone flap.
3. The purpose of this procedure is to treat craniosynostosis, a condition characterized by the premature fusion of cranial sutures in young children.
4. After removing the bone flap, the provider then reshapes the skull bones to give them an anatomically appropriate shape.
5. Finally, the provider sutures the scalp layers together and covers the wound with a sterile dressing.

4. Qualifying circumstances

CPT 61556 is performed in cases where the patient has craniosynostosis, a congenital condition causing premature fusion of cranial sutures in young children. The procedure involves the removal of a frontal or parietal bone flap during a craniotomy. It is important to note that this procedure is typically performed by a qualified healthcare professional with expertise in craniofacial surgery.

5. When to use CPT code 61556

CPT code 61556 should be used when a craniotomy is performed specifically to remove a frontal or parietal bone flap for the treatment of craniosynostosis. It is important to accurately document the procedure and ensure that it aligns with the official description of CPT 61556.

6. Documentation requirements

To support a claim for CPT 61556, the healthcare professional must document the following information:

• Patient’s diagnosis of craniosynostosis
• Specific details of the procedure, including the removal of a frontal or parietal bone flap
• Date of the procedure
• Any additional relevant information, such as the anatomical shape achieved or any complications encountered
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 61556, ensure that the procedure performed aligns with the official description of the code. It is important to accurately document the procedure and provide any necessary supporting documentation. Additionally, be aware of any specific billing guidelines or requirements set forth by insurance providers or regulatory bodies.

8. Historical information

CPT 61556 was added to the Current Procedural Terminology system on January 1, 1991. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A pediatric neurosurgeon performing a craniotomy to remove a frontal bone flap for the treatment of craniosynostosis in a 2-year-old patient.
2. A craniofacial surgeon performing a craniotomy to remove a parietal bone flap for the treatment of craniosynostosis in a 6-month-old infant.
3. A neurosurgeon performing a craniotomy to remove a frontal bone flap for the treatment of craniosynostosis in a 1-year-old patient.
4. A plastic surgeon performing a craniotomy to remove a parietal bone flap for the treatment of craniosynostosis in a 3-year-old child.
5. A pediatric neurosurgeon performing a craniotomy to remove a frontal bone flap for the treatment of craniosynostosis in a 4-year-old patient.
6. A craniofacial surgeon performing a craniotomy to remove a parietal bone flap for the treatment of craniosynostosis in a 9-month-old infant.
7. A neurosurgeon performing a craniotomy to remove a frontal bone flap for the treatment of craniosynostosis in a 2-year-old patient.
8. A plastic surgeon performing a craniotomy to remove a parietal bone flap for the treatment of craniosynostosis in a 5-year-old child.
9. A pediatric neurosurgeon performing a craniotomy to remove a frontal bone flap for the treatment of craniosynostosis in a 3-year-old patient.
10. A craniofacial surgeon performing a craniotomy to remove a parietal bone flap for the treatment of craniosynostosis in a 7-month-old infant.