2025 CPT code 61799
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Stereotactic radiosurgery for each additional complex cranial lesion.
Modifiers may be applicable. Modifier 59 may be used to indicate a distinct procedural service.
Medical necessity for stereotactic radiosurgery should be clearly documented. This usually includes factors such as the size, location, and type of lesion, as well as other treatment options considered.
The neurosurgeon performs the stereotactic radiosurgery procedure, including identifying the target area, using stereotactic methods and a robotic arm controlled by a computer to focus radiation on the target area.
In simple words: This is an additional procedure used to treat more complex brain lesions with radiation during the same session. It is used when there is more than one complex area needing treatment, usually with one lesion larger than 3.5 cm.
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator) for each additional cranial lesion, complex. This code is listed separately in addition to the primary procedure code (61798) and is used for each additional complex cranial lesion treated during the same session.
Example 1: A patient presents with two complex cranial lesions, one measuring 4 cm and the other 3.8 cm, located in different areas of the brain. Both lesions are treated during the same session using stereotactic radiosurgery. Code 61798 is reported for the first lesion, and 61799 is reported for the second lesion., A patient has a single, large complex lesion measuring 5 cm in diameter. Due to its proximity to critical structures, the treatment is delivered in three sessions. Code 61798 is reported once for the entire course of treatment., A patient undergoes stereotactic radiosurgery for four complex lesions during the same operative session. The largest lesion is 4 cm, with the other three being less than 3.5cm each, but complex due to their proximity to a critical structure. Code 61798 is reported once for the first complex lesion. Code 61799 is reported three times, once for each additional complex lesion.
Documentation should include the size and location of each lesion, confirmation of complexity, treatment method (particle beam, gamma ray, or linear accelerator), and the number of lesions treated during the same session. Medical necessity for stereotactic radiosurgery should also be documented.
** It is important to differentiate between simple and complex cranial lesions based on size (3.5 cm or greater is complex) and proximity to critical structures like the optic nerve. Ensure accurate documentation to support the use of code 61799.Radiation treatment management codes (77427-77435) should not be reported by the same individual performing the radiosurgery.
- Revenue Code: P1G - Major procedure - other
- Global Days : This code includes the destruction of each additional complex cranial lesion at the same session.
- Specialties:Neurosurgery, Radiation Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital