2025 CPT code 61598
Transpetrosal approach to the posterior cranial fossa, clivus, or foramen magnum, including ligation of the superior petrosal sinus and/or sigmoid sinus.
Modifiers may apply. Modifier 51 is used when multiple procedures are performed by the same surgeon.
Medical necessity is established based on the diagnosis and the need for surgical intervention. The documentation must support the chosen surgical approach as the most appropriate method to access and treat the lesion.
The surgeon performs a posterior transpetrosal approach, which involves varying degrees of removing the petrous part of the temporal bone.The dissection exposes the superior petrosal sinus, the sigmoid sinus, the posterior semicircular canal, and the area between the sphenoid, temporal, and occipital bones where the abnormality is located. The petrosal and sigmoid sinuses may be tied off to gain access to the defect.
- Surgery
- Surgical Procedures on the Nervous System;Surgical Procedures on the Skull, Meninges, and Brain; Skull Base Surgical Procedures
In simple words: The surgeon accesses the back part of the skull base using an approach that goes through the petrous part of the temporal bone.This might involve tying off certain blood vessels in the area to get a better view and access to the problem area.
This procedure involves accessing the posterior cranial fossa, clivus, or foramen magnum using a transpetrosal approach.The superior petrosal sinus and/or sigmoid sinus may be ligated to improve access to the lesion or defect. The specific approach is chosen based on the location and size of the lesion.
Example 1: A patient presents with a cholesteatoma extending into the posterior fossa. A transpetrosal approach (61598) is used to access and remove the lesion., A patient has a tumor at the base of the skull near the foramen magnum. A transpetrosal approach (61598) is chosen to allow access for resection., A patient requires surgery for a lesion affecting the clivus. The surgeon uses a transpetrosal approach (61598) to reach the affected area and perform the necessary procedure.
Documentation should include the specific approach used, the location and size of the lesion, whether the superior petrosal sinus and/or sigmoid sinus were ligated, and the operative report detailing the entire procedure.
- Specialties:Neurosurgery, Otolaryngology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center