Summary & Overview
CPT 61514: Craniotomy for Excision of Supratentorial Brain Abscess
CPT code 61514 denotes a craniotomy with excision of a supratentorial brain abscess, a high-complexity neurosurgical intervention to remove infected intracranial collections above the tentorium cerebelli. This code captures operative management of intracranial abscesses that require surgical drainage or resection and is clinically significant because timely, definitive surgical care can be lifesaving and affects hospital resource use, length of stay, and postoperative care needs.
Key payers in the national context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks and clinical context relevant to coding and billing for operative abscess management, including typical settings of care and payer coverage considerations. The publication summarizes coding intent, service lines, and where this procedure most often occurs, and it highlights common payer considerations and typical modifier usage patterns.
This overview is intended for a national audience of coding professionals, clinical directors, and revenue cycle stakeholders seeking an authoritative description of CPT code 61514, its clinical application, and the payer landscape affecting reimbursement and utilization for neurosurgical abscess management. Data not available in the input will be noted where applicable in detailed sections.
Billing Code Overview
CPT code 61514 describes a neurosurgical procedure in which a portion of the skull (craniotomy) is removed to access and excise a brain abscess located above the tentorium cerebelli. The procedure involves opening the cranial vault, identifying the abscess in the supratentorial compartment, and performing drainage and debridement or excision as clinically indicated.
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Service type: Neurosurgical operative procedure for intracranial abscess management
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Typical site of service: Hospital operating room (inpatient or outpatient surgical setting depending on clinical status)
Clinical & Coding Specifications
Clinical Context
A 48-year-old male presents to the emergency department with 3 days of worsening headache, fever, progressive confusion, and focal right-sided weakness. MRI brain with contrast demonstrates a 3.2 cm rim-enhancing lesion in the left frontal lobe with surrounding vasogenic edema and midline shift. Blood cultures are pending and the patient has a history of recent sinusitis. Neurosurgery is consulted for operative management of an intracranial abscess located above the tentorium cerebelli. After preoperative evaluation, informed consent, and administration of general anesthesia, the neurosurgeon performs a craniotomy with removal of a bone flap and surgical excision and drainage of the supratentorial brain abscess. Intraoperative cultures are obtained and wound closure is completed with standard neurosurgical techniques. Postoperative care includes ICU monitoring, targeted intravenous antibiotics guided by culture results, serial neurologic examinations, and imaging follow-up with MRI or CT to confirm adequate abscess evacuation and monitor for complications such as reaccumulation, hemorrhage, or new neurologic deficits. Typical site of service is an acute care hospital operating room; the service type is an invasive neurosurgical operative procedure for management of intracranial infection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Reserved for unspecified use by payer | Use only if a payer specifically requires this code per contract terms |