2025 CPT code 61548
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Hypophysectomy or excision of a pituitary tumor via transnasal or transseptal approach, without stereotactic guidance.
Modifiers may be applicable to this code to indicate multiple procedures (51), reduced services (52), or other circumstances as per CPT guidelines.
Medical necessity is established when the patient presents with symptoms or complications directly attributable to a pituitary tumor that necessitates surgical intervention.This may include hormonal imbalances causing endocrine dysfunction, visual field defects due to mass effect, or evidence of tumor invasion into adjacent structures.The medical necessity is determined by a physician and documented in the patient's chart.
The neurosurgeon or otolaryngologist is responsible for performing the hypophysectomy. This includes patient preparation, anesthesia selection (general anesthesia is usually used), surgical approach (transnasal or transseptal), tumor excision, tissue repair and reconstruction, possible graft placement, and wound closure. Postoperative care may involve managing potential complications such as CSF leaks and hormone imbalances.
In simple words: This surgery removes a pituitary tumor or part of the pituitary gland. The surgeon accesses the gland through the nose or mouth without using imaging guidance.The surgeon carefully removes the tumor and repairs the area. Sometimes, a small tissue graft is used to prevent fluid leakage.
This procedure involves the resection of a portion of the pituitary gland or the excision of a pituitary tumor. Access to the gland is achieved through either a transnasal or transseptal approach, without the use of image guidance.A transseptal approach involves an incision beneath the upper lip, dissection along the nasal septum to the sphenoid sinus, opening the dura mater, identifying the sella turcica, and excising the tumor or a portion of the gland. A transnasal approach involves an incision in the nasal cavity, followed by similar steps to access and remove the pituitary tissue.Following the excision, tissue and bone are reconstructed and closed.A fat or fascia graft may be used to prevent cerebrospinal fluid leakage; the graft is harvested from the lower abdomen or thigh, respectively, and the harvest site is sutured. The wound is covered with a sterile dressing.
Example 1: A 45-year-old female presents with symptoms of a prolactinoma (pituitary tumor causing excess prolactin), including amenorrhea and galactorrhea.A transnasal hypophysectomy is performed to remove the tumor., A 60-year-old male presents with visual field defects due to a large pituitary adenoma compressing the optic chiasm. A transseptal approach is used to perform a hypophysectomy, relieving the pressure on the optic nerves and improving his vision., A 30-year-old female presents with Cushing's disease due to an ACTH-secreting pituitary adenoma.A transnasal hypophysectomy is performed to remove the tumor and reduce excess cortisol production.
* Preoperative assessment, including neurological exam, visual fields, and hormonal levels.* Operative report detailing the surgical approach, size and location of the tumor, extent of resection, and any complications.* Histopathology report confirming the diagnosis and nature of the resected tissue.* Postoperative hormonal levels and neurological assessment.* Any imaging studies (MRI, CT) performed before and after surgery.
** This code specifically excludes procedures using stereotactic guidance.The choice of transnasal vs. transseptal approach depends on the location and size of the tumor and surgeon preference.Postoperative management often includes hormone replacement therapy due to the potential for pituitary dysfunction.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Information not available in source.
- Global Days: Information not available in source.
- Payment Status: Active
- Modifier TC rule: Information not available in source.
- Fee Schedule: Information not available in source.
- Specialties:Neurosurgery, Otolaryngology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center