2025 CPT code 61651
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Additional intracranial artery access for long-term non-thrombolytic drug administration; includes catheter placement, diagnostic angiography, and imaging guidance.
Modifiers may apply depending on the circumstances of the procedure. Consult the CPT manual and payer-specific guidelines for appropriate modifier usage.
The medical necessity for this procedure is established by the need for long-term targeted drug delivery to specific intracranial arteries to manage neurological conditions such as brain tumors, AVMs, or stroke sequelae. Appropriate documentation demonstrating the need for additional arterial access for optimal drug distribution is essential.
The physician performs the procedure under imaging guidance. This includes making incisions, inserting needles and guidewires, advancing catheters, performing diagnostic angiography, and connecting the catheter to a drug delivery system.
In simple words: This code covers placing a catheter in an artery inside the skull to give medicine over a long time. It's only used if the doctor has already placed a catheter in one artery and needs to add another. The procedure uses imaging to guide the placement and includes tests to check the artery's condition.This code is only used with another main code; it cannot be billed on its own.
This CPT code, 61651, represents the endovascular intracranial prolonged administration of pharmacologic agents (excluding thrombolytics) via an arterial approach.The procedure involves catheter placement in each additional intracranial artery beyond the initial one, accompanied by diagnostic angiography and image guidance.This is an add-on code requiring a primary procedure code for reimbursement.It bundles catheter placement, diagnostic angiography, and imaging guidance; these should not be separately coded.
Example 1: A patient with a brain arteriovenous malformation (AVM) requires long-term medication delivery to manage the condition. After initial catheter placement in one artery, the physician accesses two additional arteries to optimize drug distribution, utilizing code 61651 twice in addition to the primary procedure code., A patient presents with a recurrent brain tumor following prior treatment.The neurosurgeon places a catheter in the primary feeding artery for chemotherapy administration and subsequently identifies two additional smaller vessels requiring catheter placement for complete treatment, thus needing code 61651 to be reported twice in addition to the primary procedure code., A patient undergoing treatment for a stroke requires long-term medication delivery to a specific area of the brain.After the initial catheter placement, the physician determines that additional arterial access is needed to optimize drug delivery, resulting in the use of code 61651 once in addition to the primary procedure code.
Detailed operative notes specifying the number of additional intracranial arteries accessed, the location of each access site, the type of catheter used, the type and amount of medication administered, and the results of the diagnostic angiography.Imaging studies (angiograms) must be included.
** Payers may have specific coverage policies for this code; verification with individual payers is recommended prior to billing.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Technical component (TC) modifiers may be applicable based on the provider's role and participation in the procedure. Consult payer guidelines for specific requirements.
- Specialties:Neurosurgery, Interventional Neuroradiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center