2025 CPT code 61450
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion
Modifiers such as 22 (Increased Procedural Services), 51 (Multiple Procedures), 52 (Reduced Services), etc., may be applicable depending on the specific circumstances of the procedure.
Medical necessity for 61450 must be established by documenting the severity of the patient's symptoms, failure of conservative treatments, and the impact of the condition on the patient's quality of life.
The surgeon performs the procedure, including prepping and anesthetizing the patient, making the incision, exposing the skull, creating a bone flap, opening the dura, manipulating the trigeminal nerve, closing the dura and wound, and placing a drain.
In simple words: The surgeon makes an opening in the skull beneath the temple to access and treat the trigeminal nerve. This procedure is typically done to relieve severe facial pain caused by trigeminal neuralgia.The surgeon lifts a piece of the skull, works on the nerve, and then replaces the bone and closes the incision.
This procedure involves creating an opening in the skull below the temples to access the sensory root of the gasserian ganglion (trigeminal nerve). The surgeon may then section, compress, or decompress the nerve root to alleviate facial nerve pain, such as trigeminal neuralgia.The procedure involves an incision, bone flap removal, dural opening, manipulation of the nerve root, dural closure, bone flap replacement, and wound closure.
Example 1: A patient presents with excruciating facial pain diagnosed as trigeminal neuralgia. Medication and less invasive procedures have failed to provide relief.A subtemporal craniectomy is performed to decompress the trigeminal nerve root., A patient with trigeminal neuralgia refractory to medical management undergoes a subtemporal craniectomy for sectioning of the sensory root of the gasserian ganglion., A patient with a tumor compressing the trigeminal nerve undergoes a subtemporal craniectomy to access and remove the tumor, followed by decompression of the affected nerve root.
Documentation should include the diagnosis (trigeminal neuralgia or other indication), previous treatments tried, operative report detailing the procedure, including the specific technique used (sectioning, compression, or decompression), and post-operative notes.
** This code is for the surgical approach and manipulation of the trigeminal nerve. It does not include other procedures that may be performed concurrently, such as tumor removal. Be sure to choose the correct code and add modifiers to give as specific information as needed.For injection procedures related to cerebral angiography, ventriculography, or pneumoencephalography, different codes apply (36100-36218, 61026, 61120, 61055).
- Revenue Code: P1G - Major Procedure - Other
- Payment Status: Active
- Specialties:Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center