CPT® Code 61154

A burr hole craniotomy is a surgical procedure that involves creating one or more small openings, known as burr holes, in the skull to facilitate the evacuation and drainage of hematomas, which can be either extradural or subdural. This procedure is typically indicated when there is a collection of blood that needs to be removed to alleviate pressure on the brain. The process begins with an incision in the scalp, which is then flapped forward to provide access to the skull. A specialized surgical drill or perforator is used to create the burr hole, penetrating both the outer and inner tables of the skull. In cases of extradural hematomas, the blood collection is situated between the inner table of the skull and the dural membrane, while subdural hematomas involve blood accumulation between the dura mater and the arachnoid membranes. The procedure allows for the insertion of a cannula, which is equipped with a stylet, to access the hematoma site. Once the cannula is in place, a syringe is used to flush out the blood from the hematoma. After the evacuation of the hematoma, the dura is closed, and the defect in the skull is repaired, often using bone wax to ensure proper closure. It is important to note that this code does not apply to the aspiration of an intracerebral hematoma or cyst, which is a different procedure requiring a distinct approach and coding (CPT® Code 61156).