CPT® Code 61542

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The procedure described by CPT® Code 61542 involves a craniotomy with elevation of the bone flap for a total hemispherectomy. In simpler terms, this surgical intervention is performed on the brain, which is divided into two halves known as the right and left cerebral hemispheres. Each hemisphere consists of an outer layer of grey matter, referred to as the cerebral cortex, and an inner layer of white matter. These two hemispheres are connected by a structure called the corpus callosum. A hemispherectomy is a surgical procedure that entails the total or partial removal of one of the cerebral hemispheres, and in the case of code 61542, a complete removal, known as an anatomic hemispherectomy, is performed. During an anatomic hemispherectomy, the surgeon removes the entire affected hemisphere, which includes the frontal, parietal, temporal, and occipital lobes, while leaving deeper brain structures such as the basal ganglia, thalamus, and brain stem intact. The surgical process begins with a long incision in the scalp, which is made starting from the front of the skull and extending across the midline to the opposite side. A scalp flap is then created to provide access to the skull. Burr holes are drilled into the skull, and the bone between these holes is cut and elevated to create a bone flap. The dura mater, a protective membrane covering the brain, is opened in a specific manner, allowing the surgeon to access the brain tissue. Using a surgical microscope, the surgeon carefully dissects the tissue along the interhemispheric fissure, which is the space between the two hemispheres. The callosal fibers, which connect the two hemispheres, are divided using suction aspiration and bipolar coagulation techniques. The dissection continues until the affected hemisphere is fully mobilized, at which point it is excised. This complex procedure is typically indicated for patients with severe neurological conditions that affect one hemisphere of the brain, necessitating its removal to alleviate symptoms or improve quality of life.