2025 CPT code 61790
(Active) Effective Date: N/A Revision Date: N/A Surgery - Stereotactic Procedures Nervous System Feed
Creation of a lesion in the gasserian ganglion using a stereotactic method and a neurolytic agent.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural service).
The procedure is medically necessary when conservative treatments (e.g., medications) for trigeminal neuralgia or other conditions causing severe intractable pain have failed and when the benefits of pain relief outweigh the risks of the procedure.
The physician is responsible for pre-operative assessment, selecting the appropriate stereotactic technique and neurolytic agent, performing the procedure, post-operative monitoring and management, and providing aftercare instructions to the patient.
In simple words: This is a procedure to relieve nerve pain.The doctor uses imaging to precisely target a group of nerves (gasserian ganglion) in the brain and destroys part of it using a special method to reduce pain signals.
This procedure involves the percutaneous creation of a lesion in the gasserian ganglion using a stereotactic technique.The procedure begins with the identification of the target area using three-dimensional brain imaging (CT or MRI scans). A small incision is made, and a hollow needle or other instrument is guided to the target area using stereotactic coordinates. A neurolytic agent (e.g., alcohol, electric current, or radiofrequency) is then used to destroy the gasserian ganglion. Finally, the instrument is withdrawn, and the incision is closed.
Example 1: A 65-year-old patient presents with intractable trigeminal neuralgia unresponsive to medical management.A stereotactic radiofrequency lesioning of the gasserian ganglion is performed to alleviate the chronic pain., A 58-year-old patient experiences severe, persistent pain secondary to a tumor compressing the trigeminal nerve.Pre-operative imaging guides a stereotactic alcohol injection into the gasserian ganglion to provide pain relief before surgical resection of the tumor., A 72-year-old patient with a history of multiple sclerosis develops severe trigeminal neuralgia.A stereotactic procedure using an electrical current is chosen for creating a lesion in the gasserian ganglion to manage their symptoms.
* Thorough history and physical examination documenting the nature and severity of the pain.* Pre-operative imaging (CT or MRI) clearly demonstrating the gasserian ganglion and any relevant anatomical structures.* Operative report detailing the surgical technique, neurolytic agent used, and assessment of lesion placement.* Post-operative imaging (if performed).* Documentation of pain assessment before and after the procedure.* Medical necessity justification for the procedure, including failed conservative treatment attempts.
** The selection of the neurolytic agent and the specific stereotactic technique used should be documented in detail.Consideration should be given to the patient's overall health status and potential risks associated with the procedure.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Neurosurgery, Neurology, Pain Management
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)