How To Use CPT Code 61584

CPT 61584 describes the orbitocranial approach to the anterior cranial fossa, specifically for accessing an extradural lesion or defect at the skull base. 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 61584?

CPT 61584 can be used to describe the orbitocranial approach to the anterior cranial fossa, without orbital exenteration. This code is specifically for accessing an extradural lesion or defect at the skull base. The procedure may involve an osteotomy of the supraorbital ridge and the elevation of the frontal and/or temporal lobes, depending on the location and size of the lesion.

2. Official Description

The official description of CPT code 61584 is: ‘Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration.’

3. Procedure

1. The provider performs an orbitocranial approach to access the anterior cranial fossa.
2. An osteotomy of the supraorbital ridge is performed to gain access to the lesion or defect.
3. The frontal and/or temporal lobes may be elevated to further expose the area.
4. The provider addresses the extradural lesion or defect as necessary.
5. The procedure is completed without orbital exenteration.

4. Qualifying circumstances

CPT 61584 is used when the provider needs to access an extradural lesion or defect at the skull base using an orbitocranial approach. This approach is chosen based on the location and size of the lesion. The procedure may involve an osteotomy of the supraorbital ridge and the elevation of the frontal and/or temporal lobes. It is important to note that orbital exenteration is not included in this procedure.

5. When to use CPT code 61584

CPT code 61584 should be used when the provider performs an orbitocranial approach to access an extradural lesion or defect at the skull base, without performing orbital exenteration. This code is specific to cases where the lesion or defect is located in the anterior cranial fossa and requires an extradural approach.

6. Documentation requirements

To support a claim for CPT 61584, the provider must document the following information:

• Reason for the procedure and the need to access the extradural lesion or defect
• Details of the orbitocranial approach, including the osteotomy of the supraorbital ridge
• Elevation of the frontal and/or temporal lobes, if performed
• Description of the lesion or defect addressed during the procedure
• Any additional procedures, repairs, or reconstructions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 61584, ensure that the procedure meets the criteria for an orbitocranial approach to the anterior cranial fossa, without orbital exenteration. It is important to accurately document the details of the procedure and any additional services provided. Report other surgeries, repairs, or reconstructions separately, if applicable.

8. Historical information

CPT 61584 was added to the Current Procedural Terminology system on January 1, 1994. It 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 provider performs an orbitocranial approach to access an extradural lesion in the anterior cranial fossa, without orbital exenteration.
2. An osteotomy of the supraorbital ridge is performed, and the frontal lobe is elevated to expose the lesion.
3. The provider addresses the extradural defect and completes the procedure without any additional repairs or reconstructions.
4. In another case, a provider performs an orbitocranial approach to access an extradural defect in the anterior cranial fossa, without orbital exenteration.
5. An osteotomy of the supraorbital ridge and elevation of the temporal lobe are performed to expose the defect.
6. The provider addresses the extradural defect and performs a reconstruction procedure to repair the area.
7. Another provider performs an orbitocranial approach to access an extradural lesion in the anterior cranial fossa, without orbital exenteration.
8. An osteotomy of the supraorbital ridge and elevation of both the frontal and temporal lobes are performed to expose the lesion.
9. The provider addresses the extradural lesion and performs a separate repair procedure to reconstruct the area.
10. In a different case, a provider performs an orbitocranial approach to access an extradural lesion in the anterior cranial fossa, without orbital exenteration.
11. An osteotomy of the supraorbital ridge is performed, and the frontal lobe is elevated to expose the lesion.
12. The provider addresses the extradural lesion and performs an additional surgery to repair the area.