How To Use CPT Code 61686

CPT 61686 describes a surgical procedure for the removal of an intracranial arteriovenous malformation (AVM) located in the infratentorial region of the brain. This article will provide an overview of CPT 61686, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 61686?

CPT 61686 is a code used to describe a surgical procedure that involves the removal of an intracranial arteriovenous malformation (AVM) located in the infratentorial region of the brain. This region is situated below the tentorium cerebella, a fold of dura mater that separates the cerebellum from the occipital and temporal lobes. The procedure is specifically performed for complex AVMs, which are larger than 3 cm in size and may involve deep venous drainage and portions of the cortex related to important functions such as senses, speech, and language.

2. Official Description

The official description of CPT code 61686 is: ‘Surgery of intracranial arteriovenous malformation; infratentorial, complex.’

3. Procedure

1. The surgical procedure begins with the provider making an incision in the scalp above the area where the arteriovenous malformation is located.
2. A circular portion of bone is then removed using a drilling technique or another suitable method.
3. The provider gains access to the AVM, which is situated in a challenging area of the brain below the tentorium cerebella.
4. The AVM is carefully separated from the surrounding brain tissue, and the abnormal vessels are resected.
5. If there is any excess fluid or blood, it is drained using a drain.
6. The layers of dural tissue are sutured together, and the bone flap may be reattached using plates, wires, or sutures.
7. Finally, the wound is covered with a sterile dressing.

4. Qualifying circumstances

CPT 61686 is performed on patients with complex intracranial arteriovenous malformations (AVMs) that are larger than 3 cm in size and may involve deep venous drainage and portions of the cortex related to important functions. The procedure is typically performed by a qualified healthcare professional who specializes in neurosurgery or a related field.

5. When to use CPT code 61686

CPT code 61686 should be used when a surgical procedure is performed to remove a complex intracranial arteriovenous malformation (AVM) located in the infratentorial region of the brain. It is important to ensure that the AVM meets the qualifying circumstances described above before using this code.

6. Documentation requirements

To support a claim for CPT code 61686, the healthcare professional must document the following information:

• Patient’s diagnosis and the presence of a complex intracranial arteriovenous malformation (AVM)
• Description of the surgical procedure performed, including the specific techniques used
• Date of the surgery
• Details of any complications or unexpected findings during the procedure
• Post-operative care instructions and any follow-up appointments scheduled
• Signature of the healthcare professional performing the surgery

7. Billing guidelines

When billing for CPT code 61686, it is important to ensure that the procedure performed meets the criteria for a complex intracranial arteriovenous malformation (AVM) located in the infratentorial region of the brain. It is also essential to follow any specific billing guidelines provided by the payer or insurance company. Additionally, it is important to review any applicable modifiers or additional codes that may be required for accurate billing.

8. Historical information

CPT code 61686 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. However, it is worth noting that Medicare made a change in 2017, adding this procedure to the Inpatient Only (IPO) list.

9. Examples

1. A neurosurgeon performing a surgical procedure to remove a complex intracranial arteriovenous malformation (AVM) located in the infratentorial region of the brain.
2. A patient with a large AVM involving deep venous drainage and portions of the cortex related to speech undergoing surgery to remove the AVM.
3. A neurosurgical team performing a complex procedure to resect an intracranial AVM larger than 3 cm in size.
4. A patient with a complex AVM in the infratentorial region of the brain undergoing surgery to separate and remove the abnormal vessels.
5. A neurosurgeon performing a surgical procedure to remove a complex AVM below the tentorium cerebella.
6. A patient with a complex AVM requiring surgery to prevent further complications and improve overall brain function.
7. A neurosurgical team performing a complex procedure to resect an AVM involving deep venous drainage and portions of the cortex related to senses.
8. A patient with a complex AVM in the infratentorial region of the brain undergoing surgery to restore normal blood flow and reduce the risk of neurological deficits.
9. A neurosurgeon performing a surgical procedure to remove a complex AVM larger than 3 cm in size.
10. A patient with a complex AVM requiring surgery to alleviate symptoms and improve quality of life.