CPT® Code 61140

A burr hole or trephine procedure involves the creation of a small opening in the skull to facilitate the biopsy of brain tissue or an intracranial lesion. This procedure is essential for diagnosing various neurological conditions by allowing direct access to the brain or lesions located within the cranial cavity. The process begins with an incision in the scalp, which is then flapped forward to expose the underlying bone. A surgical drill or perforator is utilized to create a burr hole, which is a precise and controlled method of penetrating the skull. In some cases, a trephine may be employed to remove a small disc of bone, providing an alternative approach to accessing the intracranial structures. Once the skull is opened, the dura mater, which is the protective membrane covering the brain, is incised to allow access to the brain tissue. To manage any bleeding that may occur during the procedure, electrocautery is used effectively. A biopsy needle is then inserted through the opening to obtain a tissue sample from the brain or the lesion in question. After the sample is collected, the needle is carefully withdrawn, and the dura is closed to protect the brain. Finally, the skull defect is repaired either by replacing the bone disc that was removed or by applying bone wax to ensure proper closure and stability of the cranial cavity.