How To Use CPT Code 61581

CPT 61581 describes the craniofacial approach to the anterior cranial fossa, specifically for extradural lesions or defects. 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 61581?

CPT 61581 is used to describe the craniofacial approach to the anterior cranial fossa, specifically for extradural lesions or defects. This code encompasses procedures such as lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy, and/or maxillectomy. The selection of the specific approach depends on the location and size of the lesion or defect.

2. Official Description

The official description of CPT code 61581 is: ‘Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy, and/or maxillectomy.’

3. Procedure

1. The craniofacial approach to the anterior cranial fossa is performed to access an extradural lesion or defect at the base of the skull.
2. The procedure involves accessing the hollow area bounded by the orbital plates of the frontal bone, cribriform plate of the ethmoid, and the frontal portion of the sphenoid bone.
3. To access the lesion or defect, the provider may perform lateral rhinotomy, which involves an incision into the side of the nose.
4. Excision of the entire or a portion of the cube-shaped ethmoid bone may be necessary.
5. Partial or complete removal of the sphenoid bone, situated at the base of the skull, may also be performed.
6. Surgical removal of the diseased maxilla, which is the upper jaw, may be necessary.
7. In some cases, orbital exenteration, which involves the removal of the contents of the orbit, such as the eye or part of the bony orbit, may be performed.
8. The specific procedures performed will depend on the location and extent of the lesion or defect.

4. Qualifying circumstances

CPT 61581 is used for patients who require a craniofacial approach to the anterior cranial fossa for the treatment of extradural lesions or defects. This approach is typically used when the lesion or defect is located in the hollow area bounded by the orbital plates of the frontal bone, cribriform plate of the ethmoid, and the frontal portion of the sphenoid bone. The specific procedures performed may vary depending on the location and extent of the lesion or defect.

5. When to use CPT code 61581

CPT code 61581 should be used when a craniofacial approach is performed to access an extradural lesion or defect in the anterior cranial fossa. This code is specifically for procedures that involve lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy, and/or maxillectomy. It is important to note that this code is not appropriate for intradural procedures or procedures performed in other cranial fossae.

6. Documentation requirements

To support a claim for CPT code 61581, the provider must document the following information:

• Diagnosis indicating the presence of an extradural lesion or defect in the anterior cranial fossa
• Description of the specific procedures performed, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy, and/or maxillectomy
• Date of the procedure
• Any additional relevant details, such as the location and extent of the lesion or defect
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 61581, it is important to ensure that the procedure performed meets the criteria outlined in the code description. This includes the use of a craniofacial approach to access an extradural lesion or defect in the anterior cranial fossa, as well as the performance of lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy, and/or maxillectomy. It is also important to follow any additional guidelines provided by payers or coding authorities.

8. Historical information

CPT code 61581 was added to the Current Procedural Terminology system on January 1, 1994. 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 undergoes a craniofacial approach to the anterior cranial fossa for the removal of an extradural lesion using lateral rhinotomy and sphenoidectomy.
2. A provider performs a craniofacial approach to the anterior cranial fossa to access an extradural defect, performing orbital exenteration and ethmoidectomy.
3. A craniofacial approach is used to treat an extradural lesion in the anterior cranial fossa, with the provider performing maxillectomy and sphenoidectomy.
4. A patient requires a craniofacial approach to the anterior cranial fossa for the excision of an extradural lesion, with the provider performing lateral rhinotomy and ethmoidectomy.
5. A provider performs a craniofacial approach to the anterior cranial fossa to access an extradural defect, performing orbital exenteration and maxillectomy.
6. A craniofacial approach is used to treat an extradural lesion in the anterior cranial fossa, with the provider performing lateral rhinotomy and sphenoidectomy.