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2025 CPT code 61340

Subtemporal cranial decompression for pseudotumor cerebri or slit ventricle syndrome.

Refer to the AMA CPT manual and other relevant coding guidelines for proper use of modifier -50 for bilateral procedures.

Modifier -50 is used for bilateral procedures.Other modifiers may be applicable based on individual circumstances (e.g., -22 for increased procedural services, -51 for multiple procedures).

Medical necessity is established by the presence of symptoms and imaging findings consistent with increased intracranial pressure that is causing significant neurological or visual impairment.Conservative management should have been attempted and failed prior to surgical intervention.

The neurosurgeon performs the subtemporal craniectomy, including incision, bone flap creation and removal, duraplasty, and wound closure. Anesthesiologist provides anesthesia and monitors the patient during the procedure.

IMPORTANT For bilateral procedures, use modifier -50. For decompressive craniotomy or craniectomy for intracranial hypertension without hematoma evacuation, see codes 61322 and 61323.

In simple words: This surgery relieves pressure on the brain.The doctor removes a piece of the skull near the temples and opens the protective covering of the brain to lower pressure. This is done for conditions causing increased pressure inside the skull.

Subtemporal cranial decompression involves removing a portion of the skull beneath the temporal muscle and opening the dura to relieve intracranial pressure.This procedure is indicated for pseudotumor cerebri (idiopathic intracranial hypertension) or slit ventricle syndrome, a complication of shunt implantation. The surgeon incises the scalp, exposes the bone, creates burr holes, removes a bone flap, opens the dura to release pressure, and then closes the wound with plates, wires, and screws.

Example 1: A 35-year-old female presents with severe headaches, blurred vision, and papilledema.Imaging reveals increased intracranial pressure without a clear cause (idiopathic intracranial hypertension). Subtemporal decompression is performed to relieve the pressure., A 50-year-old male with a history of hydrocephalus and shunt placement develops slit ventricle syndrome.Subtemporal decompression is performed to address the resulting increased intracranial pressure., A 28-year-old female presents with progressive headaches and visual disturbances consistent with pseudotumor cerebri. Subtemporal decompression is elected as the initial treatment strategy to reduce intracranial pressure, improving visual symptoms and headache severity.

* Preoperative neurological examination and imaging (CT or MRI) demonstrating increased intracranial pressure.* Operative report detailing the surgical technique, including the size and location of the bone flap removed.* Postoperative neurological examination and imaging to assess for complications.

** The use of burr holes in conjunction with this procedure should be appropriately documented and may require additional coding considerations.

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