2025 CPT code 61640
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel.
Modifiers such as 22 (Increased Procedural Services), 52 (Reduced Services), 53 (Discontinued Procedure), and others may be applicable depending on the circumstances of the procedure.
Medical necessity is established by demonstrating the presence of symptomatic intracranial vasospasm, typically resulting from conditions like subarachnoid hemorrhage or head injury.The documentation should clearly link the vasospasm to the patient's symptoms and explain how the balloon angioplasty will improve blood flow and alleviate those symptoms.
The physician performs diagnostic angiograms, administers heparin, monitors clotting time, catheterizes the femoral artery, places and inflates the angioplasty balloon, and performs follow-up angiograms.
In simple words: The doctor inserts a thin tube through an artery in the leg and guides it to a narrowed blood vessel in the brain. A tiny balloon is then inflated to widen the narrowed vessel, improving blood flow. This is often done after a type of bleeding in the brain.
This procedure involves percutaneous intracranial angioplasty to dilate an intracranial vessel using a balloon. It's typically performed to widen a vasospastic segment (narrowing of the blood vessel), often occurring after an acute subarachnoid hemorrhage.The procedure involves diagnostic angiograms to confirm the vasospasm, heparin administration, and femoral artery catheterization.Angiography is used throughout to guide catheter and balloon placement and to confirm successful dilation.
Example 1: A patient presents with vasospasm following a subarachnoid hemorrhage.Angiography confirms the location and severity of the vasospasm, and 61640 is performed to dilate the affected vessel., A patient experiencing stroke symptoms due to intracranial vasospasm undergoes balloon angioplasty (61640) to restore blood flow., Following a head injury, a patient develops vasospasm leading to neurological deficits.61640 is performed to address the vasospasm and alleviate the symptoms.
Documentation should include diagnostic angiograms confirming the vasospasm, details of heparin administration and clotting time monitoring, procedure notes describing catheter and balloon placement and dilation, and post-procedure angiogram results.Medical necessity for the procedure, related to the underlying condition and symptoms, should also be documented.
- Revenue Code: P1G
- Specialties:Interventional Radiology, Neurosurgery, Neurology
- Place of Service:Inpatient Hospital, Outpatient Hospital