How To Use CPT Code 61608

CPT 61608 describes the resection or excision of neoplastic, vascular, or infectious lesions in the parasellar area, cavernous sinus, clivus, or midline 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 61608?

CPT 61608 can be used to describe the surgical removal of neoplastic, vascular, or infectious lesions located in the parasellar area, cavernous sinus, clivus, or midline skull base. This code is used when the provider performs partial or complete removal of the lesion, including intradural procedures and dural repair if necessary.

2. Official Description

The official description of CPT code 61608 is: ‘Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft.’

3. Procedure

1. The provider prepares the patient and accesses the skull base.
2. Using surgical techniques, the provider removes a portion or all of the neoplastic, vascular, or infectious lesion located in the parasellar area, cavernous sinus, clivus, or midline skull base.
3. If necessary, the provider performs dural repair, which may include the use of a dural graft.
4. The procedure may also involve surgical reconstruction of the dura mater.

4. Qualifying circumstances

CPT 61608 is performed on patients with neoplastic, vascular, or infectious lesions located in the parasellar area, cavernous sinus, clivus, or midline skull base. The procedure is intradural, meaning it is performed within the dura mater, and may involve dural repair with or without a graft. The lesions may be benign or cancerous, and the procedure is performed by a qualified provider.

5. When to use CPT code 61608

CPT code 61608 should be used when the provider performs the resection or excision of neoplastic, vascular, or infectious lesions located in the specified areas of the skull base. This code is appropriate when the procedure is intradural and includes dural repair, with or without a graft. It is important to ensure that the documentation supports the use of this code and accurately describes the procedure performed.

6. Documentation requirements

To support a claim for CPT 61608, the provider must document the following information:

• Patient’s diagnosis and the presence of neoplastic, vascular, or infectious lesions
• Details of the procedure performed, including the specific areas of the skull base involved
• Description of the resection or excision of the lesion
• Documentation of any dural repair, including the use of a graft if applicable
• Any additional procedures performed, such as surgical reconstruction of the dura mater
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 61608, ensure that the procedure meets the criteria outlined in the official description. The documentation should support the use of this code and accurately describe the procedure performed. It is important to follow the guidelines provided by the payer and use appropriate modifiers if necessary. Additionally, be aware of any specific billing requirements or restrictions set by the payer.

8. Historical information

CPT 61608 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 neurosurgeon performs the resection of a neoplastic lesion in the parasellar area of a patient’s skull base, including intradural dural repair.
2. A vascular surgeon excises an infectious lesion located in the cavernous sinus, performing intradural dural repair with a graft.
3. A neurologist removes a vascular lesion in the midline skull base, performing intradural dural repair without a graft.
4. An otolaryngologist resects a neoplastic lesion in the clivus, performing intradural dural repair with a graft.
5. A neurosurgeon performs the excision of an infectious lesion in the parasellar area, including intradural dural repair and surgical reconstruction of the dura mater.
6. A neurosurgeon removes a neoplastic lesion in the midline skull base, performing intradural dural repair without a graft.
7. A vascular surgeon excises a vascular lesion in the cavernous sinus, performing intradural dural repair without a graft.
8. An otolaryngologist resects an infectious lesion in the clivus, performing intradural dural repair with a graft.
9. A neurologist removes a neoplastic lesion in the parasellar area, including intradural dural repair and surgical reconstruction of the dura mater.