How To Use CPT Code 61760

CPT 61760 describes the stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring. 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 61760?

CPT 61760 can be used to describe the procedure of implanting depth electrodes into the cerebrum of the brain for long-term seizure monitoring. This code is used when a provider uses three-dimensional imaging to map the implant location and identifies the abnormal area of the brain causing a patient’s epileptic seizures.

2. Official Description

The official description of CPT code 61760 is: ‘Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring.’

3. Procedure

1. The provider begins by taking computed tomography (CT) or magnetic resonance imaging (MRI) scans to locate the coordinates in the brain for electrode placement.
2. Once the patient is prepped and anesthetized, the provider makes an incision in the scalp and retracts the flap to expose the bone.
3. Burr holes or holes are made in the skull to access the site, and the provider incises the dura.
4. A small probe is inserted, gradually moving brain tissue away along its path to the target point identified by the CT or MRI mapped coordinates.
5. The provider places thin wire electrodes, known as depth electrodes, into the brain.
6. The electrodes are connected to continuous electroencephalogram (EEG) equipment to monitor brain activity.
7. The provider records activity between events (interictal activity) and during seizures (ictal activity) for analysis.
8. Using a computer, the provider analyzes the recordings to identify the seizure focal point, or where the seizure begins.
9. The bone flap is replaced and secured with permanent plates, wires, and screws.
10. The tissue flap is folded back, the scalp is closed, and a sterile dressing is applied.

4. Qualifying circumstances

CPT 61760 is performed on patients with epileptic seizures to identify the abnormal area of the brain causing the seizures. The procedure involves the stereotactic implantation of depth electrodes into the cerebrum. It is important to note that this procedure is typically performed by a neurosurgeon or a provider with specialized training in stereotactic techniques.

5. When to use CPT code 61760

CPT code 61760 should be used when a provider performs the stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring. It is important to ensure that the procedure is performed for the purpose of identifying the seizure focal point and not for other reasons, such as diagnostic imaging or therapeutic interventions.

6. Documentation requirements

To support a claim for CPT 61760, the provider must document the following information:

• Indication for the procedure, including the patient’s history of epileptic seizures
• Documentation of the preoperative imaging studies used to locate the coordinates for electrode placement
• Description of the surgical approach, including the incision, burr holes, and electrode placement
• Details of the continuous EEG monitoring during and after the procedure
• Analysis of the EEG recordings to identify the seizure focal point
• Description of any additional procedures performed during the same operative session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 61760, it is important to ensure that the procedure meets the criteria for long-term seizure monitoring and is performed using stereotactic techniques. This code should not be reported with other codes unless additional procedures were performed during the same operative session. It is also important to follow any specific billing guidelines provided by the payer or Medicare.

8. Historical information

CPT 61760 was added to the Current Procedural Terminology system on January 1, 1993. The code underwent a change on January 1, 2008, with an updated description. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A neurosurgeon performing the stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring in a patient with refractory epilepsy.
2. A provider using three-dimensional imaging to map the implant location and identify the seizure focal point in a patient with intractable seizures.
3. A neurologist performing the stereotactic implantation of depth electrodes into the cerebrum to monitor brain activity and identify the abnormal area causing a patient’s epileptic seizures.
4. A provider using continuous EEG monitoring to record interictal and ictal activity in a patient undergoing long-term seizure monitoring with depth electrodes.
5. A neurosurgeon analyzing EEG recordings to identify the seizure focal point and determine the appropriate treatment plan for a patient with medically refractory epilepsy.
6. A provider performing the stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring as part of a comprehensive evaluation for epilepsy surgery.
7. A neurologist using stereotactic techniques to place depth electrodes into the cerebrum and monitor brain activity in a patient with drug-resistant seizures.
8. A provider performing the stereotactic implantation of depth electrodes into the cerebrum to identify the seizure focal point and guide the placement of a neurostimulator for deep brain stimulation.
9. A neurosurgeon using three-dimensional imaging to map the implant location and place depth electrodes into the cerebrum for long-term seizure monitoring in a patient with focal epilepsy.