Summary & Overview
CPT 61751: Image-Guided Intracranial Lesion Biopsy or Excision
CPT code 61751 represents an image-guided neurosurgical procedure involving a craniotomy to biopsy, aspirate, or excise an intracranial lesion with intraoperative CT and/or MRI guidance. The code captures advanced intraoperative imaging use during tissue diagnosis or lesion removal and is relevant for hospitals and surgical centers that provide neurosurgical oncology and complex intracranial procedures. Nationally, this code matters for payment policy, coding accuracy, and tracking use of intraoperative imaging in neurosurgery.
Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national overview of how this service is billed and categorized, common clinical contexts for its use, and the operational settings where it typically occurs.
Readers will learn the clinical scope of CPT code 61751, the typical site of service and service type, and the implications for facility and professional billing workflows. The piece summarizes benchmarks and coding considerations relevant to hospitals and outpatient surgical centers, highlights areas where documentation supports use of intraoperative CT/MRI, and outlines what is available and what is not provided in the input. Data not available in the input includes payer-specific reimbursement rates, associated taxonomies, and ICD-10 diagnosis pairings.
Billing Code Overview
CPT code 61751 describes a neurosurgical procedure in which the surgeon removes a portion of the skull (craniotomy) to biopsy, aspirate, and/or excise an intracranial lesion using intraoperative computed tomography (CT) and/or magnetic resonance imaging (MRI) guidance. This procedure is image-guided and performed to obtain tissue for diagnosis or to remove pathological intracranial material.
-
Service type: Image-guided intracranial lesion biopsy and/or excision
-
Typical site of service: Hospital operating room or other inpatient/outpatient surgical setting where intraoperative CT or MRI is available
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents with new-onset focal neurological deficits and progressive headaches. MRI of the brain demonstrates a contrast-enhancing, deep-seated intracranial lesion thought to be a glioma versus metastatic disease. The neurosurgery team schedules an operative craniotomy with image-guidance. In the operating room, the surgeon performs a limited craniectomy, then biopsies, aspirates, or excises the intracranial lesion using intraoperative CT and/or MRI to confirm lesion location, assess extent of resection, and reduce risk to adjacent eloquent cortex. Intraoperative imaging is integrated into the surgical workflow for registration and real-time verification: preoperative images are fused, navigation systems guide the approach, the lesion is sampled or resected, and intraoperative CT/MRI scans are obtained to evaluate residual tumor and to guide further resection if necessary. Typical perioperative personnel include the neurosurgeon, anesthesiologist, neurophysiologist (if monitoring), radiology technologist for intraoperative imaging, and operating room nursing staff. The typical site of service is an acute care hospital operating room with intraoperative imaging capability, and the procedure is performed under general anesthesia. Postoperative workflow includes immediate recovery room monitoring, postoperative imaging as indicated, and neuropathology processing of biopsy specimens for definitive diagnosis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |