How To Use CPT Code 61585

CPT 61585 describes the orbitocranial approach to the anterior cranial fossa, which involves 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 61585?

CPT 61585 can be used to describe the orbitocranial approach to the anterior cranial fossa, specifically for accessing an extradural lesion or defect at the skull base. This procedure involves making an incision into the bony brow ridge, separating the frontal and/or temporal lobes, and performing orbital exenteration if necessary. The selection of this approach depends on the location and size of the lesion.

2. Official Description

The official description of CPT code 61585 is: ‘Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration.’

3. Procedure

1. The provider accesses the anterior cranial fossa using an orbitocranial approach.
2. An incision is made into the bony brow ridge, located above the eye sockets.
3. The frontal and/or temporal lobes are separated to access the extradural lesion or defect.
4. If necessary, orbital exenteration is performed, which involves the removal of the contents of the orbit, such as the eye or part of the bony orbit.

4. Qualifying circumstances

CPT 61585 is used when there is a need to access an extradural lesion or defect at the skull base using the orbitocranial approach. This approach is typically chosen based on the location and size of the lesion. It is important to note that this code specifically refers to an extradural procedure, meaning it is performed outside the dura mater, which is the outermost membrane covering the brain.

5. When to use CPT code 61585

CPT code 61585 should be used when the provider performs an orbitocranial approach to access an extradural lesion or defect at the anterior cranial fossa. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including the supraorbital ridge osteotomy, elevation of frontal and/or temporal lobe(s), and potential orbital exenteration.

6. Documentation requirements

To support a claim for CPT code 61585, the provider must document the following information:

• Reason for the procedure and the need to access the anterior cranial fossa
• Details of the orbitocranial approach, including the supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s)
• Description of any additional procedures performed, such as orbital exenteration
• Date and duration of the procedure
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 61585, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should also consider any additional procedures performed, such as orbital exenteration, and report them separately if necessary. It is important to review the payer’s guidelines and policies to ensure accurate and appropriate billing.

8. Historical information

CPT code 61585 was added to the Current Procedural Terminology system on January 1, 1994. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A patient undergoes CPT code 61585 for the removal of an extradural lesion at the anterior cranial fossa using the orbitocranial approach.
2. A provider performs CPT code 61585 to access and repair a defect at the skull base using the supraorbital ridge osteotomy and elevation of frontal lobe(s).
3. An individual undergoes CPT code 61585 with orbital exenteration for the treatment of a large orbital tumor.
4. A provider performs CPT code 61585 to access and remove a foreign body at the anterior cranial fossa using the orbitocranial approach.
5. A patient undergoes CPT code 61585 with osteoplastic flap and internal fixation for the repair of a defect at the skull base.
6. A provider performs CPT code 61585 with osteoplastic flap and bone graft to reconstruct the anterior cranial fossa after the removal of a lesion.
7. An individual undergoes CPT code 61585 with osteoplastic flap, internal fixation, and bone graft for the repair of a complex defect at the skull base.
8. A patient undergoes CPT code 61585 for the exploration and repair of the frontal sinus using the orbitocranial approach.
9. A provider performs CPT code 61585 with orbital exenteration and bone graft for the treatment of a large orbital tumor and reconstruction of the anterior cranial fossa.
10. An individual undergoes CPT code 61585 with osteoplastic flap and elevation of temporal lobe(s) for the access and repair of a defect at the skull base.