Summary & Overview
CPT 61340: Temporal Craniectomy for Intracranial Pressure Decompression
CPT code 61340 specifies a temporal craniectomy and dural opening to decompress the brain beneath the temples and relieve elevated intracranial pressure. The procedure is clinically important for patients with idiopathic intracranial hypertension (pseudotumor cerebri) and for those with slit ventricle syndrome after shunt placement. Nationally, this code captures a high-acuity neurosurgical intervention with implications for inpatient surgical capacity and postoperative critical care resources.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications, typical sites of service, and the service type tied to this code. The publication also summarizes payer coverage patterns and benchmarks where available, highlights relevant billing and documentation considerations, and provides context on clinical scenarios that commonly result in use of this code. Policy updates and payer-specific authorization practices that affect access and reimbursement for cranial decompression procedures are covered at a national level.
Intended for hospital billing teams, neurosurgeons, and policy analysts, this summary frames 61340 within clinical practice and the payer environment so stakeholders can understand when the code is used and what operational and policy factors influence its utilization.
Billing Code Overview
CPT code 61340 describes a neurosurgical decompression procedure in which part of the skull beneath the temporal muscle is removed and the dura is opened to relieve elevated intracranial pressure. The procedure addresses conditions such as idiopathic intracranial hypertension (pseudotumor cerebri) and slit ventricle syndrome, a shunt-related complication causing excess cerebrospinal fluid (CSF) buildup.
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Service type: Neurosurgical cranial decompression for intracranial pressure relief
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Typical site of service: Inpatient operating room or surgical suite, often followed by inpatient monitoring
Clinical & Coding Specifications
Clinical Context
A 28-year-old woman presents with daily, severe headaches, transient visual obscurations, and pulsatile tinnitus. Neuro-ophthalmologic exam demonstrates bilateral papilledema. Neuroimaging (MRI/MRV) reveals no mass lesion or venous sinus thrombosis; lumbar puncture shows elevated opening pressure consistent with idiopathic intracranial hypertension (pseudotumor cerebri). After maximal medical therapy including acetazolamide and weight reduction fails and vision worsens, the neurosurgery team schedules a unilateral temporal decompression with removal of a portion of the temporal bone and dural opening to decrease intracranial pressure and protect vision.
The clinical workflow includes preoperative evaluation (neuroimaging, ophthalmology baseline visual fields and optic nerve assessment, anesthetic assessment), informed consent documenting indications and risks, operative procedure performing a temporal decompressive craniectomy/craniotomy with dural opening, postoperative neurocritical monitoring for intracranial pressure and neurologic status, and follow-up ophthalmology and neurosurgery visits to assess visual function and wound healing. Typical site of service is an inpatient operating room within a hospital; the service type is a major surgical intracranial decompression procedure for elevated intracranial pressure such as idiopathic intracranial hypertension or complications of CSF shunting (slit ventricle syndrome).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — no modifier |