Summary & Overview
CPT 61320: Supratentorial Intracranial Abscess Drainage
CPT code 61320 denotes a neurosurgical craniotomy/craniectomy to open the skull above the tentorium and drain an intracranial abscess. The procedure relieves mass effect and infection-related pressure from focal abscesses caused by penetrating injury or microbial invasion, and it may be performed as a primary drainage or for recurrent collections after initial aspiration. Nationally, this code represents high-acuity operative care typically performed in hospital operating rooms with multidisciplinary perioperative and inpatient management needs.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing overview, expected site-of-service context, common modifier usage (listed separately in reference sections), and guidance on where this service typically fits within neurosurgical practice patterns. The publication summarizes coding intent, service setting, and the clinical circumstances that justify operative drainage of supratentorial abscesses, and provides benchmarking and policy-relevant context where payer coverage patterns and prior authorization practices commonly apply.
This national summary is intended for clinicians, coding professionals, and policy analysts seeking a clear description of the procedure represented by CPT code 61320, associated service context, and the payer landscape relevant to inpatient neurosurgical drainage of intracranial abscesses.
Billing Code Overview
CPT code 61320 describes a neurosurgical procedure in which the provider creates an opening in the skull above the tentorium to drain and relieve pressure from an intracranial abscess. The procedure addresses focal pus collections that arise from penetrating head trauma or from bacterial or fungal infections and may be performed as an initial operative drainage or as a subsequent procedure if the abscess recurs after prior aspiration or drainage.
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Service type: Neurosurgical operative drainage of intracranial abscess (craniotomy/craniectomy approach above the tentorium)
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Typical site of service: Hospital operating room or inpatient surgical unit for neurosurgical intervention
Clinical & Coding Specifications
Clinical Context
A 45-year-old male presents to the emergency department with escalating headache, fever, focal neurologic deficits, and imaging demonstrating a 3.5 cm ring-enhancing collection in the cerebral hemisphere with surrounding vasogenic edema and midline shift. Blood cultures are pending and the patient has a history of chronic sinusitis. Neurosurgery is consulted and takes the patient to the operating room for craniotomy and drainage of the intracranial abscess. The clinical workflow includes preoperative assessment, informed consent, CT and MRI review, general anesthesia, creation of a skull opening above the tentorium, evacuation and culture of purulent material, hemostasis, placement of a drain if indicated, postoperative ICU monitoring, targeted intravenous antibiotics guided by microbiology, and follow-up imaging to confirm resolution. The procedure described by 61320 is used when definitive surgical drainage via craniotomy is required rather than bedside aspiration, and it may be billed as a primary procedure or for repeat drainage if recurrence occurs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Not typically appended; indicates default. |
11 |