Was there any mention that the bone flap was replaced? Or is this the entire report?
61510-The physician removes a flap of bone from the skull to access and remove a brain tumor located underneath. The flap of bone is removed with the help of a hand-operated drill.
Generally speaking, the terms craniotomy and craniectomy are used interchangeably within the CPT book. Whenever the code descriptor includes the terminology "craniotomy or craniectomy" the associated code may be used regardless of whether a craniotomy or craniectomy was performed.
In large part, the difference in terminology generally reflects how the part of the cranium that was removed in order to gain access to inside the skull is treated upon completion of the procedure. In a craniectomy, portions of the skull or bone flap used to gain access to the inside of the cranium are permanently removed and is not returned to the patient's body upon completion of the procedure. Conversely, when the term craniotomy is used, it usually describes a procedure where the bone flap is returned to its normal position prior to closure.
This is why I asked about the flap.
A craniectomy or craniotomy also can be used to find and remove a brain tumor. In general the scalp incisions, bone openings and exposures of the brain tend to be larger than necessary to ensure that the surgeon can actually find the brain tumor within the craniotomy opening.
CPT codes 61510 and 61518 report different types of tumors other than a meninigioma. This may include benign brain tumors such as epidermoid tumors, dermoid tumors, hemangioblastomas, colloid cysts, subependymal giant cell astrocytomas, and pleomorphic xanthoastrocytomas. Malignant tumor can be either primary or secondary sites. A primary malignant brain tumor starts from cells in the brain. When related to the nervous system, they often are called gliomas .
I would probably query your physician a little more since I really don't think 61304 reports the work involved.
