2025 CPT code 61559
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Craniectomy or Craniotomy Procedures Surgery Feed
Extensive craniectomy for multiple cranial suture craniosynostosis; recontouring with osteotomies and bone autografts.
Modifiers may be applicable to this code based on the circumstances of the surgery, such as 22 (increased procedural service) or 51 (multiple procedures) for additional osteotomies, or 78 or 79 (unplanned return to the OR).Refer to the CPT manual and payer guidelines for modifier usage instructions.
Medical necessity is established by the presence of craniosynostosis causing significant cosmetic deformity, intracranial pressure elevation, or neurological compromise. Documentation should include evidence of the deformity's impact on the child's development and well-being.
The neurosurgeon is primarily responsible for performing this complex procedure.Anesthesiologists and potentially other surgical team members will participate depending on the complexity of each individual case. Post-operative care involves collaboration with neurosurgery, nursing, and possibly other specialists depending on individual case complexities.
- Surgery
- Surgery > Surgical Procedures on the Nervous System > Craniectomy or Craniotomy Procedures
In simple words: This surgery corrects a condition where a baby's skull bones fuse too early, causing an abnormally shaped head. The surgeon removes part of the skull, reshapes the bones, and uses bone grafts from the patient's own body to reconstruct it, allowing for normal skull growth.
This CPT code, 61559, represents an extensive craniectomy performed to address multiple cranial suture craniosynostosis, a condition characterized by the premature fusion of skull sutures.The procedure involves the removal of a significant portion of the cranium, followed by meticulous reshaping and recontouring of the cranial bones using multiple osteotomies. Bone autografts are harvested and used to facilitate the reconstruction process, ensuring adequate space for brain growth and achieving an anatomically correct skull shape. The procedure includes the procurement and integration of the bone grafts.
Example 1: A 6-month-old infant presents with a cloverleaf skull deformity due to craniosynostosis.The neurosurgeon performs a 61559 procedure, including extensive craniectomy, bone remodeling with osteotomies, and autologous bone grafting for reconstruction. , A 1-year-old child is diagnosed with sagittal craniosynostosis causing significant head asymmetry. The neurosurgeon performs a 61559 procedure to reshape the skull and restore normal growth. Autologous bone grafts are used for reconstruction., An infant with complex craniosynostosis requiring multiple osteotomies and significant bone grafting for reconstruction of the skull undergoes a 61559 procedure. The procedure involves significant bone resection, reshaping, and autograft placement to allow for normal cranial growth and development.
* Preoperative imaging (CT scan, MRI) to assess the extent of craniosynostosis and plan the surgical approach.* Operative report detailing the extent of craniectomy, number and location of osteotomies, type and amount of bone graft used, and closure technique.* Pathology report if any suspicious tissue is removed.* Postoperative imaging to evaluate the effectiveness of the reconstruction.* Detailed photographs documenting the preoperative and postoperative skull morphology.* Complete anesthesia records.
** This procedure is highly specialized and requires a skilled neurosurgeon with expertise in craniofacial surgery. The complexity of the case, including the extent of craniosynostosis and the need for bone grafting, will significantly impact the total procedure time and the level of resources required.Always confirm correct coding with the latest CPT codebook and payer specific guidelines.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: This information is not available from the provided sources.Consult the current year's CPT codebook or a reliable medical billing resource for RVU data.
- Global Days : The global period for this procedure is likely to be substantial, possibly extending beyond 90 days, given the complexity of the surgery and potential for post-operative complications.This should be determined based on payer-specific guidelines and local practices.
- Payment Status: Active
- Modifier TC rule: The TC (Technical Component) modifier typically would not apply to this surgical procedure, as the professional component is inherent to the surgical performance.
- Fee Schedule : Historical fee schedule data is not included in the provided text. Consult a reliable medical billing resource for historical fee schedule data.
- Specialties:Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center