CPT® Code 61536

Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)

The CPT® Code 61536 refers to a surgical procedure known as a craniotomy with elevation of the bone flap, specifically performed for the excision of a cerebral epileptogenic focus. This procedure is characterized by the inclusion of electrocorticography during surgery, which is a technique used to monitor electrical activity in the brain. The process begins with the reopening of a previously made surgical site, where an electrode array may have been placed to identify the source of epileptic seizures. The removal of this electrode array is a critical step, as it allows for direct access to the brain tissue that needs to be evaluated and potentially excised. The procedure involves making a skin incision along the original incision lines, raising scalp flaps, and elevating a bone flap to access the underlying brain. Depending on the type of electrode array used—either epidural or subdural—the appropriate removal technique is employed. Following the removal of the electrode array, electrocorticography is performed by placing electrodes on the surface of the cerebral cortex and, if necessary, deeper into the brain. This allows for the recording of brain wave activity, which aids in identifying the boundaries of the epileptogenic focus. Once the abnormal brain tissue is located, it is excised, and the procedure concludes with the careful closure of the dura, replacement of the bone flap, and layered closure of the scalp. This comprehensive approach ensures that the epileptogenic focus is effectively addressed while minimizing potential complications associated with the surgery.