CPT® Code 61737

Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)

Laser interstitial thermal therapy (LITT) is a sophisticated and 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 area within the brain 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 tissue. Once the laser is positioned at the lesion site, it generates 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 precise origin of the seizures can be identified. 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 lesions and plan the optimal trajectory for laser insertion. In cases where multiple or complex lesions are present, multiple trajectories may be necessary to achieve effective treatment. The procedure involves making a stab incision and drilling a burr hole, through which the fiberoptic laser is carefully navigated. Continuous MRI monitoring is employed to confirm the laser's position and to regulate the temperature of the surrounding tissues, ensuring that only the intended lesion is ablated. Upon completion of the procedure, the laser is withdrawn, and the incision site is irrigated and closed. It is important to note that CPT® Code 61736 is designated for single trajectory ablation of a simple lesion, while CPT® Code 61737 encompasses the use of multiple trajectories for treating multiple lesions or a single complex lesion.