How To Use CPT Code 61700

CPT 61700 describes the surgical treatment of a simple intracranial aneurysm using intracranial techniques to repair the abnormal dilation of a blood vessel in 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 61700?

CPT 61700 can be used to describe the surgical treatment of a simple intracranial aneurysm using intracranial techniques. This code is specifically used for repairing the abnormal dilation of a blood vessel in the carotid circulation. The procedure aims to exclude the aneurysm from the carotid circulation while preserving blood flow and minimizing brain dissection and retraction.

2. Official Description

The official description of CPT code 61700 is: ‘Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation.’

3. Procedure

1. The surgeon performs an angiogram prior to the procedure to identify the location of the aneurysm.
2. An incision is made in the scalp over the area of the aneurysm, and the scalp is retracted to expose the skull.
3. Using a surgical drill, the surgeon creates a pattern of burr holes in the skull.
4. A craniotome, a surgical saw, is inserted through the burr holes to create a bone flap, which is then removed to expose the dura, the protective layer covering the brain.
5. The surgeon incises the dura and carefully dissects down to expose the aneurysm, identifying its neck.
6. The neck of the aneurysm is clipped, excluding adjacent vessels, while ensuring hemostasis.
7. The surgeon verifies the clip placement and closes the dura, replacing and securing the bone flap.
8. If necessary, a drain may be placed before reapproximating the tissue layers, closing the scalp, and applying sterile dressings.

4. Qualifying circumstances

CPT 61700 is used for the surgical treatment of a simple intracranial aneurysm in the carotid circulation. The aneurysm should be small, typically 15 mm or less, and located in areas of the brain that are easily accessible. The procedure should not require extra effort to control bleeding or prevent further damage to the blood vessels. The goal is to exclude the aneurysm while preserving blood flow, with minimal brain dissection and retraction.

5. When to use CPT code 61700

CPT code 61700 should be used when performing surgery to treat a simple intracranial aneurysm using intracranial techniques. It is important to ensure that the aneurysm meets the criteria for simplicity and that the procedure does not involve complex or difficult repairs. If the aneurysm requires additional efforts beyond what is typically required, modifier 22, Unusual procedural services, may be appended to the code for additional reimbursement.

6. Documentation requirements

To support a claim for CPT 61700, the surgeon must document the following information:

• Clear description of the aneurysm and its location
• Details of the surgical technique used
• Date of the procedure
• Start and end time of the procedure
• Any additional efforts or complexities involved, if applicable
• Verification of clip placement
• Any drains placed, if applicable
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 61700, ensure that the procedure meets the criteria for a simple intracranial aneurysm and that the surgical techniques used are appropriate. If the aneurysm requires a complicated or difficult repair, modifier 22 may be appended to the code for additional reimbursement. It is important to provide clear and concise documentation describing the additional work performed and the reasons for its complexity. Check individual payer guidelines for specific requirements.

8. Historical information

CPT 61700 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2001, with the description specifying the carotid circulation. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A surgeon performs CPT 61700 to repair a simple intracranial aneurysm in the carotid circulation of a patient.
2. Using intracranial techniques, a neurosurgeon successfully treats a simple intracranial aneurysm in the carotid circulation with CPT 61700.
3. In an operating room, a surgeon performs CPT 61700 to exclude a simple intracranial aneurysm from the carotid circulation.
4. A patient undergoes CPT 61700 to repair a simple intracranial aneurysm using intracranial techniques.
5. Using CPT 61700, a neurosurgeon surgically treats a simple intracranial aneurysm in the carotid circulation of a patient.
6. A surgeon successfully performs CPT 61700 to repair a simple intracranial aneurysm in the carotid circulation.
7. In an intracranial approach, a neurosurgeon uses CPT 61700 to treat a simple intracranial aneurysm in the carotid circulation.