2025 CPT code 61313

Craniotomy or craniectomy for evacuation of supratentorial intracerebral hematoma.

Follow all relevant CPT coding guidelines and payer-specific instructions.

Modifiers may be necessary depending on the surgical approach (e.g., 59 for distinct procedural service if additional procedures are performed), laterality (e.g., 50 for bilateral procedures), or if performed by an assistant surgeon.

Medical necessity is established by the presence of a supratentorial intracerebral hematoma causing significant neurological compromise or risk of herniation.Conservative management is usually attempted first (e.g., medical management of swelling); however, surgical evacuation is medically necessary when conservative measures fail or are insufficient to address the life-threatening condition.

The neurosurgeon is responsible for pre-operative planning, performing the craniotomy/craniectomy, evacuating the hematoma, managing post-operative care, and potentially ordering follow-up imaging.

IMPORTANT For extradural or subdural hematoma evacuation in the infratentorial region, see code 61314.Distinguish between burr holes as a primary approach versus those used with craniotomy/craniectomy.If a bone flap craniotomy is performed, use the craniotomy/craniectomy code, not a burr hole code. Use appropriate modifiers if procedures are performed at different brain locations.

In simple words: Surgery to remove a blood clot from the brain. The doctor opens the skull to reach the clot, removes it, and then closes the skull.

This procedure involves a craniotomy or craniectomy to access and evacuate a hematoma located supratentorially within the brain's cerebrum.The surgeon makes an incision, exposes the skull, and drills burr holes (or uses a craniotome for craniectomy) to access the brain. The dura mater is opened, the hematoma is identified and removed using suction, and the surgical site is irrigated and closed.If a craniectomy was performed, the bone flap is replaced and secured; otherwise, a drain might be placed to manage swelling. The scalp is closed with sutures or staples.

Example 1: A patient presents post-trauma with a large supratentorial intracerebral hematoma causing significant neurological deficits.A craniotomy is performed to evacuate the hematoma, relieving pressure on the brain., A patient experiences a spontaneous intracerebral hemorrhage resulting in a supratentorial hematoma.A craniectomy is performed to decompress the brain, with the bone flap not immediately replaced to allow for potential swelling., A patient develops a supratentorial hematoma following a surgical procedure.A craniotomy is performed to evacuate the hematoma, addressing a complication of the initial surgery.

** This code encompasses both craniotomy and craniectomy procedures.The choice of procedure depends on the clinical judgment of the neurosurgeon based on the size and location of the hematoma, and the degree of brain swelling.

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