How To Use CPT Code 61735

CPT 61735 describes the creation of a lesion using a stereotactic method, including burr hole(s) and localizing and recording techniques, in subcortical structures other than the globus pallidus or thalamus. 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 61735?

CPT 61735 is used to describe a surgical procedure that involves the creation of a lesion in subcortical structures of the brain using a stereotactic method. This procedure includes the use of burr hole(s) and localizing and recording techniques to accurately target the specific area of the brain. It is important to note that this code is specifically for lesions created in subcortical structures other than the globus pallidus or thalamus.

2. Official Description

The official description of CPT code 61735 is: ‘Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus.’

3. Procedure

1. The surgical procedure begins with a scalp incision and the creation of a burr hole(s) in the skull.
2. A small dilating probe is then inserted through the burr hole(s) and guided towards the target area in the subcortical structures of the brain.
3. Electrocautery probes are inserted through additional burr holes in the skull and used to create a lesion in the targeted subcortical structure(s).
4. The surgeon may perform two or three repeat procedures if the desired result is not achieved with the initial cingulotomy.
5. The entire procedure is performed under the guidance of MRI (magnetic resonance imaging) to ensure accurate placement of the lesion.
6. After the lesion is created, the dura is sutured and the scalp incision is closed.

4. Qualifying circumstances

CPT 61735 is performed on patients who require a cingulotomy, a psychosurgical procedure that aims to interrupt the neuronal pathways involved in the regulation of emotions and certain autonomic functions. This procedure is typically considered when other conventional modes of therapy have not been effective or when no organic pathological cause can be identified. The surgeon must perform the procedure using a stereotactic method and target subcortical structures other than the globus pallidus or thalamus.

5. When to use CPT code 61735

CPT code 61735 should be used when a surgeon performs a cingulotomy procedure using a stereotactic method to create a lesion in subcortical structures other than the globus pallidus or thalamus. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 61735, the surgeon must document the following information:

• Patient’s diagnosis and the need for a cingulotomy procedure
• Details of the stereotactic method used, including the specific subcortical structures targeted
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed, if applicable
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 61735, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The surgeon should report this code only for lesions created in subcortical structures other than the globus pallidus or thalamus. It is also important to follow any additional guidelines provided by payers or regulatory bodies.

8. Historical information

CPT 61735 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare coverage.

9. Examples

1. A surgeon performs a cingulotomy procedure using a stereotactic method to create a lesion in the subcortical structures of the brain for a patient with treatment-resistant depression.
2. A patient with obsessive-compulsive disorder undergoes a cingulotomy procedure using a stereotactic method to create a lesion in the subcortical structures of the brain.
3. A surgeon performs a cingulotomy procedure using a stereotactic method to create a lesion in the subcortical structures of the brain for a patient with chronic pain.
4. A cingulotomy procedure using a stereotactic method is performed on a patient with Tourette syndrome to create a lesion in the subcortical structures of the brain.
5. A surgeon performs a cingulotomy procedure using a stereotactic method to create a lesion in the subcortical structures of the brain for a patient with post-traumatic stress disorder.
6. A patient with severe anxiety undergoes a cingulotomy procedure using a stereotactic method to create a lesion in the subcortical structures of the brain.
7. A surgeon performs a cingulotomy procedure using a stereotactic method to create a lesion in the subcortical structures of the brain for a patient with bipolar disorder.