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2025 CPT code 61558

Extensive craniectomy for multiple cranial suture craniosynostosis (e.g., cloverleaf skull) not requiring bone grafts.

The choice between craniectomy and craniotomy codes is based on the procedure performed, not the terminology used in the documentation. For craniosynostosis, select the code that reflects the number of sutures involved and whether bone grafts were used.

Modifiers may be applicable.For example, modifier -59 may be used to indicate a distinct procedural service. -22 can be appended to indicate increased procedural services.

Medical necessity is established by the diagnosis of craniosynostosis impacting brain development, with the extensive craniectomy deemed the necessary surgical intervention.

The neurosurgeon performs the extensive craniectomy, removing and reshaping the affected cranial bones to correct the craniosynostosis.They ensure adequate blood supply to the scalp throughout the procedure.

IMPORTANT Related codes include 61550 (craniectomy for single cranial suture craniosynostosis), 61552 (craniectomy for multiple cranial sutures), 61556 (craniotomy for frontal or parietal bone flap craniosynostosis), 61557 (craniotomy for bifrontal bone flap craniosynostosis), and 61559 (extensive craniectomy with bone grafts).

In simple words: This surgery corrects a birth defect called craniosynostosis, where the skull bones fuse too early, preventing the brain from growing properly.The surgeon removes and reshapes parts of the skull to create more space for the brain.This specific procedure is for more complex cases, often called "cloverleaf skull," and doesn't involve using bone grafts.

This procedure involves an extensive craniectomy to address multiple cranial suture craniosynostosis, such as a cloverleaf skull, where bone grafts are not required.The surgeon removes portions of the skull to correct the prematurely fused sutures and allow for normal brain growth. This intricate procedure may involve reshaping the cranial bones and does not include the use of bone grafts.

Example 1: A newborn diagnosed with cloverleaf skull undergoes extensive craniectomy to address the multiple fused sutures and allow for proper brain development., An infant with severe craniosynostosis involving multiple sutures, but not a cloverleaf skull, requires an extensive craniectomy without bone grafting., A child with complex craniosynostosis requires 61558, followed by a separate procedure for forehead reconstruction (e.g. 21175) at a different encounter, which is separately billable.

Documentation should include the diagnosis of craniosynostosis, the specific sutures involved, operative report detailing the extent of the craniectomy and bone reshaping, and absence of bone grafting.

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