CPT® Code 61107

Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device

A twist drill hole is a surgical procedure that involves creating a small opening in the skull to facilitate access to the subdural space, intracerebral area, or one of the brain's ventricles. This procedure is performed using a hand twist drill, which is equipped with a safety stop that is adjusted to the anticipated thickness of the skull at the specific site where the drill hole will be made. The drill is carefully advanced through both the outer and inner tables of the skull. As the drill penetrates the inner table, a noticeable change in resistance occurs, indicating that the dura mater has been punctured. Following this, a needle is inserted through the newly created drill hole to access the subdural space or the ventricles, allowing for the aspiration of cerebrospinal fluid (CSF). The CPT® Code 61107 is specifically utilized when this twist drill hole is created for the purpose of subdural, intracerebral, or ventricular puncture, particularly when it involves the implantation of an intraventricular catheter, a pressure recording device, or other intracerebral monitoring devices. These monitoring devices are essential for measuring various physiological parameters, such as intracerebral oxygenation, blood flow, and temperature, which are critical for assessing the patient's neurological status. The procedure not only involves the creation of the twist drill hole but also the careful advancement of a catheter into the appropriate anatomical space, which may include the subdural space, the cerebrum, or one of the brain's ventricles. The catheter is then connected to drainage tubing, a pressure transducer, or other monitoring equipment, and its patency is verified, along with the testing and calibration of the monitoring system to ensure accurate readings and functionality.