2025 CPT code 61641
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Percutaneous balloon dilatation of an additional intracranial vessel in the same vascular territory, following initial intracranial vasospasm balloon dilatation.
Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier -59 (distinct procedural service) may be used if the additional dilation is performed on a distinct vessel requiring separate work and significant additional time. Refer to CPT guidelines and payer requirements for appropriate modifier use.
Medical necessity for this procedure is established when a patient presents with symptomatic intracranial vasospasm that is refractory to maximal medical therapy.The procedure is indicated to improve cerebral perfusion and neurological function.
The physician is responsible for obtaining pre-procedure diagnostic angiograms, administering intravenous heparin for anticoagulation, monitoring the patient's active clotting time (ACT), advancing the catheter, inflating the balloon to dilate the vessel, performing post-procedure angiograms to assess for complications, and managing any complications.
In simple words: This code describes a procedure where a doctor uses a tiny balloon to open a narrowed blood vessel in the brain.This is done after a similar procedure was already performed on another blood vessel in the same area of the brain.The doctor uses special imaging and dye to guide and check the procedure.
This CPT code, 61641, reports the percutaneous balloon dilatation of each additional intracranial vessel within the same vascular territory as a previously dilated vessel.The procedure follows an initial balloon dilatation for intracranial vasospasm.It involves advancing a catheter, guided by fluoroscopy, to the stenotic site.A balloon is then inflated to dilate the vessel, followed by contrast injection to confirm dilatation. Repeat angiograms are performed to assess for restenosis or complications. This add-on code is used in conjunction with the primary procedure code (e.g., 61640) for the initial dilatation.
Example 1: A patient presents with symptomatic vasospasm in the anterior cerebral artery following a subarachnoid hemorrhage. After initial balloon dilatation of the main branch (61640), a secondary branch is found to be also significantly narrowed. 61641 is added to bill for the dilatation of this secondary branch., A patient with a history of aneurysm rupture experiences vasospasm in multiple branches of the middle cerebral artery. The physician performs the initial balloon angioplasty (61640) and then dilates two additional branches in the same vascular territory.Two units of 61641 are reported., During balloon angioplasty for intracranial vasospasm, the physician encounters unexpected additional vasospasm in a different vascular territory, requiring another procedure. The initial procedure (61640) is billed, along with an additional code 61642 for the unrelated area.
* Pre-procedure angiograms demonstrating the location and severity of vasospasm.* Intraoperative fluoroscopy images showing catheter placement and balloon inflation.* Post-procedure angiograms to confirm successful dilatation and rule out complications.* Documentation of heparin administration, ACT monitoring, and any complications encountered.* Operative report detailing the procedure and results.* Patient's medical history, including details of the underlying condition leading to vasospasm (e.g., subarachnoid hemorrhage).
** The use of 61641 is strictly limited to additional vessels within the same vascular territory.If the additional vessel(s) are in different territories, code 61642 should be used instead.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: Information not available in provided text.RVUs vary based on geographic location and other factors. Consult a relevant fee schedule for specific values.
- Global Days: Information not available in provided text. Global surgical days will depend on payer-specific rules and local custom.
- Payment Status: Active
- Modifier TC rule: No information available in provided text regarding TC modifiers for this code.Refer to CPT guidelines and local payer policies.
- Fee Schedule: Information not available in the provided text.Consult local fee schedules and historical data for fee information.
- Specialties:Neurology, Neurosurgery, Interventional Radiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital