How To Use CPT Code 61563

CPT 61563 describes the excision of a benign tumor of the cranial bone, both intra and extracranial, without optic nerve decompression. 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 61563?

CPT 61563 can be used to describe the excision of a benign tumor of the cranial bone, both intra and extracranial, without optic nerve decompression. This code is used when the provider makes an incision in the scalp over the tumor and removes the affected bone, without relieving pressure on the optic nerve.

2. Official Description

The official description of CPT code 61563 is: ‘Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the scalp over the cranial bone tumor.
3. The affected portion of the skull bone is removed, creating and removing a bone flap.
4. The provider remodels the skull defect to give it a normal shape, allowing for normal skull growth.
5. Bone grafts may be harvested and used for reconstruction to ensure proper brain growth and recontouring of the skull.
6. The scalp layers are sutured together, and a sterile dressing is applied to the wound.

4. Qualifying circumstances

CPT 61563 is performed on patients with a benign tumor of the cranial bone, such as fibrous dysplasia. The procedure does not involve decompression of the optic nerve. It is important to note that optic nerve decompression should be reported with a different CPT code, such as 61564.

5. When to use CPT code 61563

CPT code 61563 should be used when the provider performs the excision of a benign tumor of the cranial bone, both intra and extracranial, without optic nerve decompression. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 61563, the provider must document the following information:

• Patient’s diagnosis of a benign tumor of the cranial bone
• Description of the procedure performed, including the specific bone involved
• Date of the procedure
• Details of the surgical technique used
• Any bone grafts used for reconstruction
• Details of the closure and dressing applied

7. Billing guidelines

When billing for CPT 61563, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the procedure and any additional services provided. Optic nerve decompression should be reported with a different CPT code, such as 61564. Be aware of any specific billing guidelines or requirements from payers.

8. Historical information

CPT 61563 was added to the Current Procedural Terminology system on January 1, 1991. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs an excision of a benign tumor of the cranial bone, known as fibrous dysplasia, without optic nerve decompression.
2. A patient undergoes surgery for the removal of a benign tumor in the cranial bone, without optic nerve decompression.
3. A provider excises a benign tumor of the cranial bone, intra and extracranial, without decompressing the optic nerve.
4. A patient with a benign tumor of the cranial bone undergoes a surgical procedure to remove the tumor, without optic nerve decompression.
5. A provider performs an excision of a fibrous dysplasia tumor in the cranial bone, without decompressing the optic nerve.
6. A patient undergoes surgery for the removal of a benign tumor in the cranial bone, both intra and extracranial, without optic nerve decompression.
7. A provider excises a benign tumor of the cranial bone, without decompressing the optic nerve.
8. A patient with a benign tumor of the cranial bone undergoes a surgical procedure to remove the tumor, without optic nerve decompression.
9. A provider performs an excision of a fibrous dysplasia tumor in the cranial bone, without decompressing the optic nerve.
10. A patient undergoes surgery for the removal of a benign tumor in the cranial bone, both intra and extracranial, without optic nerve decompression.