Wiki 61518 or 61584

[lec121661]

Good morning,
I am torn between two codes on how to code this procedure I am leaning more towards 61518 any help would be greatly appreciated. see op note below

nature of operatin: left sided frontotemporal craniotomy and gross total excision of skull base tumor.

operative procedure: The patient was taken to the operating room following administration of general anesthesia placed supine. head secured with three point fixation utilizing a skull fixation device. The standard pterional incision was then created and carried down to the level of the periosteum. The flap was elevated and stripped anteriorly all he time, leaving the fascia of the temporalis muscle intact. the tumor capsule was easily dissected away from the subgaleal tissue. as the falp was reflected anteriorly. a fascial incision was created in the temporalis muscle, approximately 1 cm away from the visual limits of the tumor and carried down inferiorly into the frontozygomatic region as well as posteriorly into the superior temporal line.


thank you all
lec121661

 

[drramasubbu29780@gmail.com]

Hi

CPT 61584 deals only with the approach procedure i.e., trans-orbital. Surgeries at base of skull involves the method of approach, surgery proper (excision, biopsy, etc) and reconstruction.

So CPT 61584 alone is inadequate to fully qualify the procedure, in this case it is the excision of tumor. Moreover, the approach you suggest is of fronto-temporal instead of orbital.

I think CPT 61518 is a better choice than 61584, but the diagnosis should be a tumor which is not a meningioma, CP Angle tumor or a midline tumor as we have specific code-sets.

Hope this helps.

 

[lec121661]

yes thank you