How To Use CPT Code 61598

CPT 61598 describes the transpetrosal approach to the posterior cranial fossa, clivus, or foramen magnum, including the ligation of the superior petrosal sinus and/or sigmoid sinus. 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 61598?

CPT 61598 can be used to describe a surgical procedure that involves accessing the posterior cranial fossa, clivus, or foramen magnum using a transpetrosal approach. This approach may also include the ligation of the superior petrosal sinus and/or sigmoid sinus to better access the lesion or defect. The specific approach used will depend on the location and size of the abnormality being treated.

2. Official Description

The official description of CPT code 61598 is: ‘Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus.’

3. Procedure

1. The surgeon utilizes a transpetrosal approach to access the posterior cranial fossa, clivus, or foramen magnum.
2. If necessary, the surgeon may also ligate the superior petrosal sinus and/or sigmoid sinus to improve access to the lesion or defect.
3. The degree of resection of the petrous temporal bone may vary depending on the specific case.
4. The dissection exposes the superior petrosal sinus, sigmoid sinus, posterior semicircular canal, and the region between the sphenoid, temporal, and occipital bones where the abnormal tissue is located.
5. Techniques such as tying off the petrosal and sigmoid sinuses with a suture or wire may be used to gain access to the tissue defect.

4. Qualifying circumstances

CPT 61598 is typically performed on patients who require surgical treatment for lesions or defects in the posterior cranial fossa, clivus, or foramen magnum. The procedure may involve the ligation of the superior petrosal sinus and/or sigmoid sinus to improve access to the affected area. The specific circumstances that qualify for this procedure will depend on the patient’s condition and the surgeon’s assessment.

5. When to use CPT code 61598

CPT code 61598 should be used when a surgeon performs a transpetrosal approach to access the posterior cranial fossa, clivus, or foramen magnum, and includes the ligation of the superior petrosal sinus and/or sigmoid sinus. This code should be used for each instance of the procedure performed. It is important to note that CPT code 61598 should not be reported if the procedure was performed in the previous seven days.

6. Documentation requirements

To support a claim for CPT 61598, the surgeon must document the following information:

• Reason for the procedure and the specific abnormality being treated
• Details of the transpetrosal approach used
• Documentation of the ligation of the superior petrosal sinus and/or sigmoid sinus, if performed
• Date of the procedure
• Any additional procedures or repairs performed
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 61598, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the specific approach used and any additional procedures performed. Consider the use of modifiers if necessary, and be aware of any specific billing guidelines provided by insurance payers. It is also important to note that CPT 61598 should not be reported if the procedure was performed in the previous seven days.

8. Historical information

CPT 61598 was added to the Current Procedural Terminology system on January 1, 1994. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes a transpetrosal approach to access a lesion in the posterior cranial fossa, with ligation of the superior petrosal sinus.
2. A surgeon performs a transpetrosal approach to treat a defect in the clivus, including the ligation of the sigmoid sinus.
3. A patient requires a transpetrosal approach to access a lesion in the foramen magnum, with ligation of both the superior petrosal sinus and sigmoid sinus.
4. A surgeon performs a transpetrosal approach to treat a complex abnormality in the posterior cranial fossa, including the ligation of the superior petrosal sinus and repair of a dural defect.
5. A patient undergoes a transpetrosal approach to access a lesion in the clivus, with internal fixation and bone grafting.
6. A surgeon performs a transpetrosal approach to treat a defect in the foramen magnum, with internal fixation, bone grafting, and repair of a cerebrospinal fluid leak.