CPT® Code 61736

Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion

Laser interstitial thermal therapy (LITT) is a specialized, minimally invasive surgical technique utilized for the treatment of intracranial lesions. This procedure employs a laser that is delivered through a thin fiber optic cable, which is precisely guided to the target lesion using real-time magnetic resonance imaging (MRI) mapping. The process begins with the creation of a small burr hole in the skull, allowing access to the brain. Once the laser is positioned at the lesion site, it emits heat that effectively destroys the targeted tissue. LITT is particularly beneficial for addressing recurrent brain tumors that are located deep within the brain and may not be amenable to traditional surgical approaches. Additionally, this technique can be employed to manage complications such as radiation necrosis, which can arise following radiation therapy for brain tumors, as well as to treat epilepsy when the specific area of seizure origin is identifiable. The procedure is typically performed under general anesthesia, ensuring patient comfort and safety. Prior to the intervention, stereotactic imaging, either through MRI or CT scans, is conducted to accurately locate the lesion and plan the optimal trajectory for laser insertion. In cases where multiple lesions are present or when a lesion is complex, multiple trajectories may be necessary. The procedure involves making a stab incision and drilling a burr hole, through which the fiberoptic laser is inserted and navigated to the lesion. Continuous MRI monitoring is employed to confirm the laser's position and to track the temperature of adjacent tissues, ensuring that the ablation is confined to the intended target. Upon completion of the procedure, the laser is retracted, and the incision site is irrigated and closed. The CPT® Code 61736 specifically refers to the performance of LITT for a single trajectory aimed at treating one simple lesion, distinguishing it from CPT® Code 61737, which covers cases involving multiple trajectories for either multiple lesions or a single complex lesion.