How To Use CPT Code 61566

CPT 61566 describes a specific procedure known as craniotomy with elevation of bone flap for selective amygdalohippocampectomy. This article will provide an overview of CPT 61566, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 61566?

CPT 61566 is a code that represents a surgical procedure called craniotomy with elevation of bone flap for selective amygdalohippocampectomy. This procedure involves the removal of a portion of the hippocampus and amygdala, which are structures in the brain. It is typically performed to treat epilepsy of the mesial temporal region, which includes epilepsy arising from these specific areas of the brain.

2. Official Description

The official description of CPT code 61566 is: ‘Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy.’

3. Procedure

1. The procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider makes an incision into the scalp and then the skull to expose the temporal gyrus, a ridge in the temporal lobe.
3. Intraoperative imaging guidance may be used to assist the provider during the procedure.
4. The provider uses MRI before the surgery to mark the target areas in the brain.
5. The temporal gyrus is incised in an area free of cortical vessels, and the incision is extended towards the temporal horn to expose the intraventricular anatomy.
6. The provider resects the parahippocampal gyrus, which is a ridge in the cortical area of the brain surrounding the hippocampus, while ensuring the protection of the internal carotid artery and cranial nerves.
7. The hippocampus and amygdala, two temporal lobe structures, are mobilized and resected.
8. Excess fluid or blood is drained, and hemostasis is ensured at the site.
9. The bone flap is reattached using plates, wires, or sutures, and the wound is covered with a sterile dressing.

4. Qualifying circumstances

CPT 61566 is performed for patients with epilepsy of the mesial temporal region, specifically involving the hippocampus and amygdala. The procedure is typically done by a provider who is experienced in performing craniotomy with elevation of bone flap for selective amygdalohippocampectomy. The patient must meet the criteria for this specific surgical intervention, as determined by the provider.

5. When to use CPT code 61566

CPT code 61566 should be used when a craniotomy with elevation of bone flap is performed specifically for selective amygdalohippocampectomy. It is important to ensure that the procedure meets the criteria outlined in the official description of the code. If the procedure does not involve selective amygdalohippocampectomy, a different CPT code should be used to accurately represent the performed procedure.

6. Documentation requirements

To support a claim for CPT 61566, the provider must document the following information:

• Patient’s diagnosis and indication for the procedure
• Details of the procedure performed, including the specific structures resected
• Use of intraoperative imaging guidance, if applicable
• Any additional procedures or interventions performed during the same operative session
• Any complications or unexpected findings encountered during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 61566, 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 or relevant coding guidelines. It is important to accurately document and code any additional procedures or interventions performed during the same operative session. CPT code 61566 should not be reported with other codes that describe similar procedures or interventions.

8. Historical information

CPT code 61566 was added to the Current Procedural Terminology system on January 1, 2004. It has not undergone any updates or changes since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement purposes.

9. Examples

1. A patient with epilepsy of the mesial temporal region undergoes a craniotomy with elevation of bone flap for selective amygdalohippocampectomy to treat their condition.
2. A provider performs a craniotomy with elevation of bone flap for selective amygdalohippocampectomy on a patient with drug-resistant epilepsy originating from the hippocampus and amygdala.
3. A surgical team performs a craniotomy with elevation of bone flap for selective amygdalohippocampectomy to address a patient’s refractory seizures.
4. A provider performs a craniotomy with elevation of bone flap for selective amygdalohippocampectomy on a patient with epilepsy who has failed to respond to medical management.
5. A patient with epilepsy of the mesial temporal region undergoes a craniotomy with elevation of bone flap for selective amygdalohippocampectomy to improve their seizure control.
6. A provider performs a craniotomy with elevation of bone flap for selective amygdalohippocampectomy on a patient with intractable epilepsy originating from the hippocampus and amygdala.
7. A surgical team performs a craniotomy with elevation of bone flap for selective amygdalohippocampectomy to address a patient’s medically refractory seizures.