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Functional cortical and subcortical mapping is a specialized neurosurgical procedure aimed at identifying critical areas of the brain that control essential motor and sensory functions. This process is crucial for ensuring that surgical interventions do not inadvertently damage these vital regions. During the procedure, the patient is typically sedated, and a craniotomy is performed to access the brain. Once the area of interest is exposed, the patient is awakened to allow for real-time mapping of brain activity. Electrodes are strategically placed on the brain's surface or inserted into deeper brain structures to stimulate specific regions. This stimulation helps provoke seizures or elicits responses that indicate the function of various brain areas. The information gathered during this mapping is invaluable, as it guides the neurosurgeon in planning the subsequent surgical procedure, allowing them to navigate around critical brain structures effectively. The coding for this procedure includes CPT® Code 95961 for the first hour of mapping and CPT® Code 95962 for each additional hour of attendance by a physician or qualified healthcare professional, ensuring accurate billing for the time spent on this essential aspect of the surgical process.
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The procedure of functional cortical and subcortical mapping is indicated for several specific conditions and scenarios where precise identification of brain functions is critical. These include:
The procedure for functional cortical and subcortical mapping involves several critical steps that ensure accurate identification of brain functions. These steps include:
After the functional cortical and subcortical mapping procedure, the patient is monitored closely for any immediate postoperative complications. Recovery may involve observation in a specialized unit to assess neurological function and ensure stability. The patient may experience some discomfort or temporary neurological deficits, which are typically monitored and managed by the healthcare team. Follow-up care is essential to evaluate the effectiveness of the mapping and the success of any subsequent surgical interventions. The healthcare team will provide instructions for postoperative care, including activity restrictions and signs of complications that should prompt immediate medical attention.
| Short Descr | ELECTRODE STIM BRAIN ADD-ON | Medium Descr | FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR | Long Descr | Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 5 | CCS Clinical Classification | 199 - Electroencephalogram (EEG) |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 95961 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | CR | Catastrophe/disaster related | GW | Service not related to the hospice patient's terminal condition | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 1991-01-01 | Added | First appearance in code book in 1991. |
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