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2025 CPT code 61798

Stereotactic radiosurgery for 1 complex cranial lesion using particle beam, gamma ray, or linear accelerator.

Code 61798 is reported only once per lesion per course of treatment, even if multiple sessions are required. If a new lesion is discovered and treated during the global period of the original treatment, use modifier 58 with 61798.

Modifiers may be applicable in certain situations, such as modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period) for a new lesion treated during the global period, or modifier 78 (Return to the Operating Room for a Related Procedure During the Postoperative Period) for an unplanned return to the operating room.

Medical necessity must be established by documenting the clinical indication for the procedure, such as uncontrolled seizures, persistent pain, or functional impairment, as well as the rationale for stereotactic radiosurgery over other treatment options.

The neurosurgeon is responsible for the entire procedure, including patient positioning, placement of fiducial markers or a stereotactic head frame, imaging the target area with CT or MRI, collaborating with radiation oncology to determine the appropriate radiation dose, treatment planning, and delivery of the radiation using stereotactic guidance.

IMPORTANT For simple cranial lesions, use 61796. For each additional complex cranial lesion treated during the same session, use 61799. Do not report 61798 with 61796 or with radiation treatment management codes (77427-77435). Do not report this code with 20660 or 61781-61783.

In simple words: This is a non-invasive procedure where high-dose radiation is used to treat a complex brain lesion.The lesion is precisely targeted to destroy it without surgery.

This procedure involves the use of externally generated ionizing radiation (particle beam, gamma ray, or linear accelerator) to inactivate or eradicate a single complex cranial lesion.A complex lesion is typically defined as a lesion 3.5 cm or greater in maximum dimension, or a lesion located within 5mm of critical structures such as the optic nerve, optic chasm, or optic tract. Certain types of lesions, regardless of size, are also considered complex, including schwannomas, arteriovenous malformations, pituitary tumors, glomus tumors, pineal region tumors, and cavernous sinus/parasellar/petroclival tumors. This code includes all necessary planning, dosimetry, targeting, positioning, and blocking.

Example 1: A patient with a 4 cm acoustic schwannoma undergoes stereotactic radiosurgery., A patient with an arteriovenous malformation near the optic nerve undergoes stereotactic radiosurgery., A patient with a 3.7 cm pituitary tumor undergoes stereotactic radiosurgery.

Documentation should include details of the lesion's size, location, and characteristics; confirmation of its complex nature; type of radiation used; treatment plan details, including dose and targeting information; and any complications encountered.

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