How To Use CPT Code 61567

CPT 61567 describes the procedure of craniotomy with elevation of bone flap for multiple subpial transections, with electrocorticography during surgery. 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 61567?

CPT 61567 can be used to describe a specific surgical procedure involving the elevation of a portion of the skull bone. During this procedure, the provider cuts the nerve fibers in the outer layer of the cerebral cortex in the subpial space, which is the space underneath the pia mater, the innermost layer covering the brain. Throughout the surgery, the provider records the electrical activity of the brain by placing electrodes directly on the cerebral cortex.

2. Official Description

The official description of CPT code 61567 is: ‘Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery.’

3. Procedure

1. When performing CPT 61567, the provider begins by making an incision into the scalp and drilling burr holes to remove a portion of the skull, allowing for adequate exposure of the cerebral cortex.
2. The goal of this surgery is to treat medically intractable epilepsy, meaning that drugs are not effectively controlling the condition.
3. The provider records the electrical activity of the brain by placing electrodes directly on the cerebral cortex.
4. Using information obtained from preoperative imaging, the provider localizes the affected area.
5. The provider then makes a series of parallel cuts in the horizontal nerve fibers of the brain’s outer layer, known as gray matter, while sparing the vertical fibers responsible for vital functions.
6. Excess fluid or blood is drained using a drain, and hemostasis is ensured.
7. Finally, the provider reattaches the bone flap to its original position using plates, wires, or sutures, and covers the wound with a sterile dressing.

4. Qualifying circumstances

CPT 61567 is performed for patients with medically intractable epilepsy, where drug treatment is not effectively controlling the condition. The procedure involves the cutting of nerve fibers in the outer layer of the cerebral cortex in the subpial space. The provider must also record the electrical activity of the brain using electrodes placed directly on the cerebral cortex.

5. When to use CPT code 61567

CPT code 61567 should be used when a craniotomy with elevation of bone flap is performed for multiple subpial transections, with electrocorticography during surgery. This code is specific to cases of medically intractable epilepsy that require surgical intervention. It should not be used for other types of craniotomy procedures or for epilepsy cases that can be managed with medication alone.

6. Documentation requirements

To support a claim for CPT 61567, the provider must document the following information:

• Patient’s diagnosis of medically intractable epilepsy
• Details of the surgical procedure, including the elevation of bone flap, multiple subpial transections, and electrocorticography
• Date of the surgery
• Start and end time of the procedure
• Specific techniques used during the surgery
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 61567, ensure that the procedure performed matches the description of the code. It is important to accurately document the details of the surgery and provide any necessary supporting documentation. CPT 61567 should not be reported with other codes unless additional procedures were performed during the same surgery. It is crucial to follow the specific guidelines provided by the payer and to use the appropriate modifiers if required.

8. Historical information

CPT 61567 was added to the Current Procedural Terminology system on January 1, 2004. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with medically intractable epilepsy undergoes a craniotomy with elevation of bone flap for multiple subpial transections, with electrocorticography during surgery.
2. A provider performs CPT 61567 on a patient with epilepsy that is not effectively controlled by medication alone. The surgery involves cutting nerve fibers in the outer layer of the cerebral cortex in the subpial space, while recording the electrical activity of the brain.
3. During a craniotomy with elevation of bone flap, a surgeon performs multiple subpial transections and records the electrical activity of the brain using electrodes directly on the cerebral cortex. This procedure is done to treat medically intractable epilepsy.
4. A patient with epilepsy undergoes a craniotomy with elevation of bone flap for multiple subpial transections. The provider records the electrical activity of the brain during the surgery using electrodes placed directly on the cerebral cortex.
5. For a patient with medically intractable epilepsy, a surgeon performs a craniotomy with elevation of bone flap. Multiple subpial transections are performed, and the electrical activity of the brain is recorded using electrodes placed directly on the cerebral cortex.
6. A provider performs CPT 61567 on a patient with epilepsy that is not adequately controlled by medication. The surgery involves cutting nerve fibers in the outer layer of the cerebral cortex in the subpial space, while monitoring the electrical activity of the brain.