2025 CPT code 61521
Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Craniectomy for excision of infratentorial or posterior fossa brain tumor; midline tumor at base of skull.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., increased procedural services, multiple procedures).Refer to CPT modifier guidelines for appropriate usage.
Medical necessity for 61521 is established by the presence of a symptomatic tumor located at the base of the skull that requires surgical resection. The documentation should clearly demonstrate the impact of the tumor on the patient's health and the rationale for surgical intervention.
The surgeon performs the craniectomy, tumor excision, and closure.
In simple words: The surgeon removes a part of the skull to access a tumor located at the base of the brain, either below a specific fold of tissue (tentorium cerebella) or in the back lower part of the skull (posterior fossa).The tumor is then removed. The skull bone is put back in place, and the scalp is closed.
This procedure involves the removal of a portion of the skull bone to access and excise a midline tumor located at the base of the skull, either infratentorial or in the posterior fossa.The surgeon makes an incision in the scalp, typically behind the ears, and removes a section of bone. The lateral cerebellum is retracted to expose the tumor at the skull base. The tumor is then excised.Drains may be placed to manage fluid or blood accumulation. The dura is sutured, the bone flap is reattached using plates, wires, or sutures, and the incision is closed with a sterile dressing.
Example 1: A patient presents with symptoms consistent with a meningioma located at the base of the skull in the posterior fossa. A craniectomy (61521) is performed to access and remove the tumor., An acoustic neuroma located at the cerebellopontine angle requires surgical resection. Due to its location at the base of the skull, a craniectomy (61521) is performed., A child is diagnosed with a medulloblastoma in the posterior fossa. A craniectomy (61521) is necessary to access and resect the tumor.
Documentation should include the operative report detailing the location and size of the tumor, the surgical approach, the extent of resection, and any complications encountered. Preoperative imaging studies confirming the diagnosis and location of the tumor should also be included.
- Revenue Code: P1G
- Specialties:Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center