How To Use CPT Code 61650

CPT 61650 describes the endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance for the initial vascular territory. 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 61650?

CPT 61650 is used to describe the endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance for the initial vascular territory. This code is used when a healthcare provider uses imaging guidance to place a catheter into an artery inside the skull for the long-term administration of a drug that is not a thrombolytic drug.

2. Official Description

The official description of CPT code 61650 is: ‘Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory.’

3. Procedure

1. The healthcare provider makes a small incision in the skin over the selected intracranial artery.
2. A needle is inserted through the incision, and a guide wire is passed through the needle into the artery.
3. A catheter is then passed over the guide wire into the artery.
4. Diagnostic angiography is performed to image the inside of the vessel.
5. The external end of the catheter is attached to a drug delivery system.
6. The procedure is completed.

4. Qualifying circumstances

CPT 61650 is performed when a healthcare provider needs to administer a pharmacologic agent(s) other than thrombolysis through an endovascular intracranial route. This code covers the initial vascular territory and includes catheter placement, diagnostic angiography, and imaging guidance. It is important to note that this code should not be used for thrombolytic drug administration.

5. When to use CPT code 61650

CPT code 61650 should be used when a healthcare provider performs the endovascular intracranial prolonged administration of pharmacologic agent(s) other than thrombolysis for the initial vascular territory. It should not be used for thrombolytic drug administration.

6. Documentation requirements

To support a claim for CPT 61650, the healthcare provider must document the following information:

• Specific details of the procedure performed, including catheter placement, diagnostic angiography, and imaging guidance
• Location of the selected intracranial artery
• Details of the pharmacologic agent(s) administered
• Date and duration of the procedure
• Any complications or adverse events
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 61650, ensure that the procedure meets the criteria described in the official description. It is important to note that catheter placement, diagnostic angiography, and imaging guidance are bundled into this code and should not be separately reported. Review CPT and payer-specific guidelines for any additional requirements or considerations.

8. Historical information

CPT 61650 was added to the Current Procedural Terminology system on January 1, 2016. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A neurosurgeon performs the endovascular intracranial prolonged administration of a non-thrombolytic drug for the initial vascular territory.
2. An interventional radiologist uses imaging guidance to place a catheter into an intracranial artery for the prolonged administration of a pharmacologic agent.
3. A neurologist performs diagnostic angiography during the endovascular intracranial administration of a non-thrombolytic drug.
4. A neurointerventional specialist administers a pharmacologic agent through an endovascular route for the treatment of a cerebral vascular condition.
5. A neurosurgeon performs the endovascular intracranial prolonged administration of a non-thrombolytic drug for the initial vascular territory, using imaging guidance for precise catheter placement.
6. An interventional neuroradiologist administers a pharmacologic agent through an endovascular route to treat an intracranial aneurysm.
7. A neurologist performs diagnostic angiography to assess the vascular structures before the endovascular intracranial administration of a non-thrombolytic drug.
8. A neurointerventional specialist uses imaging guidance to guide the placement of a catheter into an intracranial artery for the prolonged administration of a pharmacologic agent.
9. A neurosurgeon performs the endovascular intracranial prolonged administration of a non-thrombolytic drug for the initial vascular territory, ensuring precise catheter placement through imaging guidance.