How To Use CPT Code 61697

CPT 61697 describes the surgical treatment of a complex intracranial aneurysm using an intracranial approach specifically targeting the carotid circulation. 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 61697?

CPT 61697 can be used to describe a surgical procedure performed to treat a complex intracranial aneurysm. This procedure involves repairing an abnormal dilation or widening of a blood vessel in the internal carotid circulation using an intracranial approach. It is typically used for aneurysms that are large or located in areas of the brain that are difficult to access.

2. Official Description

The official description of CPT code 61697 is: ‘Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation.’

3. Procedure

1. The surgeon begins by making an incision in the scalp over the area of the aneurysm.
2. Using a surgical drill, the surgeon creates burr holes in the skull and removes a bone flap to expose the dura, the protective layer covering the brain.
3. The surgeon carefully dissects down to expose the aneurysm, identifying the vessels and the neck of the aneurysm.
4. Depending on the complexity of the aneurysm, the surgeon may clip the neck of the aneurysm, incise and suture the aneurysm if it has a calcified wall structure, or bypass the aneurysm before occluding it if critical vessels arise from it.
5. The surgeon ensures hemostasis and checks the repair of the vessel before closing the dura, replacing the bone flap, and closing the scalp.

4. Qualifying circumstances

CPT 61697 is used for the treatment of complex intracranial aneurysms that are typically large or located in difficult-to-access areas of the brain. The procedure may involve vessel occlusion, trapping, or cardiopulmonary bypass. The goal is to exclude the aneurysm from the cerebral circulation while preserving blood flow and minimizing brain dissection and retraction.

5. When to use CPT code 61697

CPT code 61697 should be used when performing surgery on a complex intracranial aneurysm using an intracranial approach specifically targeting the carotid circulation. It is important to accurately document the complexity of the aneurysm and the specific surgical techniques used.

6. Documentation requirements

To support a claim for CPT 61697, the surgeon must document the following information:

• Diagnosis of a complex intracranial aneurysm
• Details of the surgical approach and techniques used
• Date of the procedure
• Any additional procedures performed, such as vessel occlusion or bypass
• Confirmation of hemostasis and repair of the vessel
• Signature of the surgeon

7. Billing guidelines

When billing for CPT 61697, ensure that the procedure meets the criteria for a complex intracranial aneurysm and that the surgical approach specifically targets the carotid circulation. It is important to follow any additional guidelines provided by payers and to accurately document the complexity of the aneurysm and the surgical techniques used. CPT code 61697 should not be reported with other codes unless additional procedures were performed during the same session.

8. Historical information

CPT 61697 was added to the Current Procedural Terminology system on January 1, 2001. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A surgeon performs CPT 61697 to repair a complex intracranial aneurysm in the carotid circulation of a patient.
2. Using an intracranial approach, a neurosurgeon successfully treats a large aneurysm in the carotid circulation with CPT 61697.
3. A patient with a complex intracranial aneurysm undergoes surgery using CPT 61697 to exclude the aneurysm from the cerebral circulation.
4. A neurosurgeon performs CPT 61697 to repair a difficult-to-access aneurysm in the carotid circulation of a patient.
5. Using an intracranial approach, a surgeon successfully treats a complex aneurysm in the carotid circulation with CPT 61697.
6. A patient with a large intracranial aneurysm undergoes surgery using CPT 61697 to preserve blood flow and minimize brain dissection.
7. A neurosurgeon performs CPT 61697 to repair a complex aneurysm in the carotid circulation, ensuring hemostasis and vessel repair.
8. Using an intracranial approach, a surgeon successfully treats a difficult-to-access aneurysm in the carotid circulation with CPT 61697.
9. A patient with a complex intracranial aneurysm undergoes surgery using CPT 61697 to exclude the aneurysm from the cerebral circulation.
10. A neurosurgeon performs CPT 61697 to repair a large aneurysm in the carotid circulation, preserving blood flow and minimizing brain dissection.