How To Use CPT Code 61586

CPT 61586 describes the bicoronal, transzygomatic, and/or LeFort I osteotomy approach to the anterior cranial fossa without bone graft or internal fixation. 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 61586?

CPT 61586 can be used to describe a surgical approach to the anterior cranial fossa without bone graft or internal fixation. This code is used when the provider performs a bicoronal, transzygomatic, and/or LeFort I osteotomy approach to access a lesion or defect at the base of the skull. The specific approach used depends on the location and size of the lesion.

2. Official Description

The official description of CPT code 61586 is: ‘Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft.’

3. Procedure

1. The provider makes an incision from one temporal region to the other, traversing the upper attachment of the helix on one side and extending pre-auricularly to access the zygomatic arches.
2. The provider enters the hollow area containing the tissue defect, which is bounded by the orbital plates of the frontal bone, cribriform plate of the ethmoid, and frontal portion of the sphenoid bone.
3. A specific procedure is performed on the tissue abnormality or lesion, and the anatomy of the bony skull may be restored through internal fixation.
4. The provider closes the approach, which may require internal fixation, without the use of a bone graft.

4. Qualifying circumstances

CPT 61586 is used when the provider performs a bicoronal, transzygomatic, and/or LeFort I osteotomy approach to the anterior cranial fossa without bone graft or internal fixation. This procedure is typically performed to access a lesion or defect at the base of the skull. The specific approach used depends on the location and size of the lesion.

5. When to use CPT code 61586

CPT code 61586 should be used when the provider performs a bicoronal, transzygomatic, and/or LeFort I osteotomy approach to the anterior cranial fossa without bone graft or internal fixation. This code should not be used if bone graft or internal fixation is performed during the procedure.

6. Documentation requirements

To support a claim for CPT 61586, the provider must document the following information:

• Description of the lesion or defect at the base of the skull
• Details of the specific approach used (bicoronal, transzygomatic, and/or LeFort I osteotomy)
• Documentation of any internal fixation performed
• Confirmation that no bone graft was used
• Date of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 61586, ensure that the procedure meets the criteria for this code, including the specific approach used and the absence of bone graft or internal fixation. It is important to note that CPT 61586 should not be reported if bone graft or internal fixation is performed during the procedure. Report any additional surgeries, repairs, or reconstructions separately.

8. Historical information

CPT 61586 was added to the Current Procedural Terminology system on January 1, 1997. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs a bicoronal approach to access a lesion at the base of the skull without bone graft or internal fixation.
2. A provider performs a transzygomatic approach to access a defect at the base of the skull without bone graft or internal fixation.
3. A provider performs a LeFort I osteotomy approach to access a lesion at the base of the skull without bone graft or internal fixation.
4. A provider performs a bicoronal and transzygomatic approach to access a defect at the base of the skull without bone graft or internal fixation.
5. A provider performs a bicoronal and LeFort I osteotomy approach to access a lesion at the base of the skull without bone graft or internal fixation.
6. A provider performs a transzygomatic and LeFort I osteotomy approach to access a defect at the base of the skull without bone graft or internal fixation.
7. A provider performs a bicoronal, transzygomatic, and LeFort I osteotomy approach to access a lesion at the base of the skull without bone graft or internal fixation.
8. A provider performs a bicoronal, transzygomatic, and LeFort I osteotomy approach to access a defect at the base of the skull without bone graft or internal fixation.
9. A provider performs a bicoronal and transzygomatic approach to access a lesion at the base of the skull without bone graft or internal fixation.
10. A provider performs a bicoronal and LeFort I osteotomy approach to access a defect at the base of the skull without bone graft or internal fixation.