Summary & Overview
CPT 61522: Posterior Fossa Brain Abscess or Lesion Excision
CPT code 61522 covers neurosurgical removal of a portion of skull bone and excision of a brain abscess or lesion located below the tentorium cerebelli or within the posterior fossa. This code represents a high-acuity operative neurosurgery service that addresses infections or tumors in a compact, high-risk region near the brainstem and cerebellum. Nationwide, accurate coding for these procedures is critical for clinical documentation, appropriate hospital resource allocation, and standardized payment for complex cranial surgery.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, expected site-of-service information, and an outline of common modifiers used with complex surgical procedures. The content highlights where coding precision matters for claims adjudication and hospital billing workflows.
This publication provides benchmarks and coding guidance relevant to hospital and neurosurgery billing teams, explains clinical scenarios that commonly map to the code, and summarizes policy-relevant considerations affecting coverage and reimbursement. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 61522 describes a neurosurgical procedure in which a portion of the skull (craniectomy/craniotomy) is removed to access and excise a brain abscess or lesion located below the tentorium cerebelli or within the posterior fossa. This procedure targets pathology in the posterior cranial fossa, a compact area near the brainstem and cerebellum, and involves surgical removal of infected or abnormal intracranial tissue.
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Service type: Neurosurgical excision of intracranial abscess or posterior fossa lesion
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Typical site of service: Inpatient or outpatient hospital operating room (neurosurgery service)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents with focal neurologic deficits, fever, headache, and imaging showing a ring-enhancing posterior fossa lesion consistent with a cerebellar brain abscess or a posterior fossa tumor. The patient undergoes preoperative evaluation including neurologic exam, contrast-enhanced brain MRI, basic labs, coagulation profile, and anesthesia assessment. Neurosurgery schedules a suboccipital craniectomy to access the infratentorial compartment. In the operating room under general anesthesia the surgeon creates a skin incision, performs a craniectomy to remove a portion of skull bone, opens the dura, and evacuates the abscess or resects the lesion in the posterior fossa. Intraoperative cultures and pathologic specimens are obtained when indicated. Postoperative care includes ICU monitoring for brainstem or cerebellar swelling, repeat imaging (CT or MRI), antibiotics tailored to cultures for abscess cases, and neurorehabilitation as needed. Typical sites of service are the hospital inpatient operating room or ambulatory surgical center when clinically appropriate and safe for the patient.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required for 61522 is substantially greater than typical due to complexity, extensive dissection, or unusually prolonged operative time |