How To Use CPT Code 61559

CPT 61559 describes the extensive craniectomy procedure for multiple cranial suture craniosynostosis, involving recontouring with multiple osteotomies and bone autografts. 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 61559?

CPT 61559 can be used to describe an extensive craniectomy procedure for multiple cranial suture craniosynostosis. This involves recontouring the skull with multiple osteotomies and bone autografts, such as the barrel-stave procedure. The code includes obtaining the grafts necessary for the reconstruction. It is important to note that this code is specifically for the recontouring aspect of the procedure, and if reconstruction is performed, different codes should be used.

2. Official Description

The official description of CPT code 61559 is: ‘Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts).’ This code was added to the Current Procedural Terminology system on January 1, 1991. It is important to note that this procedure is typically performed on an inpatient basis.

3. Procedure

1. In this procedure, the provider begins by making an incision in the scalp and retracting it to expose the skull while maintaining adequate blood supply to the scalp.
2. Next, the provider makes incisions to remove the portion of the skull enclosing the brain, known as the cranium. Additional scalp and skull incisions may be made by changing the position of the patient’s head or turning the patient.
3. The goal of this procedure is to treat craniosynostosis, a condition where the cranial sutures fuse prematurely. The provider breaks and restructures the cranial bone to give it an anatomically appropriate shape, allowing the skull to grow normally.
4. If necessary, the provider may harvest bone grafts from the patient’s own body (autografts) to ensure there is enough room for brain growth and proper recontouring of the skull.
5. Once the recontouring is complete, the provider replaces the reshaped cranium bone and secures it in place.
6. Finally, the provider sutures the layers of the scalp together and applies a sterile dressing to cover the wound.

4. Qualifying circumstances

CPT 61559 is typically performed on patients with multiple cranial suture craniosynostosis, a congenital condition causing the premature fusion of cranial sutures in young children. The procedure is extensive and involves recontouring the skull with multiple osteotomies and bone autografts. It is important to note that this procedure is typically performed by a qualified healthcare professional in an inpatient setting.

5. When to use CPT code 61559

CPT code 61559 should be used when the provider performs an extensive craniectomy procedure for multiple cranial suture craniosynostosis, involving recontouring with multiple osteotomies and bone autografts. This code should not be used for other types of cranial surgeries or procedures. It is important to review the documentation and ensure that the procedure performed aligns with the description provided by CPT code 61559.

6. Documentation requirements

To support a claim for CPT code 61559, the provider must document the following information:

• Patient’s diagnosis of multiple cranial suture craniosynostosis
• Description of the extensive craniectomy procedure performed
• Details of the recontouring process, including the use of multiple osteotomies and bone autografts
• Documentation of obtaining the necessary grafts for the procedure
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure

7. Billing guidelines

When billing for CPT code 61559, it is important to ensure that the procedure performed aligns with the description provided. This code is typically used for inpatient procedures and should not be reported with other codes for reconstruction. It is important to review the specific billing guidelines provided by the payer to ensure accurate reporting and reimbursement for the procedure.

8. Historical information

CPT code 61559 was added to the Current Procedural Terminology system on January 1, 1991. There have been no updates or changes to the code since its addition. It is important to review the specific historical information provided by the payer or coding guidelines to ensure accurate reporting of the procedure.

9. Examples

1. A provider performs an extensive craniectomy procedure for multiple cranial suture craniosynostosis, involving recontouring with multiple osteotomies and bone autografts.
2. A patient with multiple cranial suture craniosynostosis undergoes an extensive craniectomy procedure, including recontouring with multiple osteotomies and bone autografts.
3. During an inpatient stay, a provider performs an extensive craniectomy procedure for a patient with multiple cranial suture craniosynostosis, involving recontouring with multiple osteotomies and bone autografts.