CPT® Code 62164

Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage

The procedure described by CPT® Code 62164 involves a neuroendoscopic approach to excise a brain tumor. Neuroendoscopy is a minimally invasive surgical technique that utilizes a specialized endoscope to visualize and access the brain's internal structures. In this procedure, a small incision is made in the scalp to expose the skull, which is then accessed through a burr hole. This burr hole allows for the insertion of the neuroendoscope into the ventricular system of the brain. The dura mater, a protective membrane covering the brain, is incised to facilitate the introduction of the neuroendoscope. Once inside, the neuroendoscope provides a view of the brain cortex, enabling the surgeon to identify the safest path for the trocar insertion, avoiding major blood vessels. The trocar, a sharp instrument, is then introduced into the ventricle, allowing the surgeon to inspect the ventricular system and locate the tumor. During this inspection, a tissue sample may be collected for pathological examination, which is reported separately. The excision of the tumor is performed using various instruments, including forceps, curettes, and suction devices, especially if the tumor is large and requires multiple passes for complete removal. To manage any bleeding during the procedure, a cautery device is utilized through the working channel of the neuroendoscope. After the tumor is excised, if necessary, an external ventricular catheter is placed for drainage. This catheter is advanced into the ventricle through the trocar, which is subsequently removed, and the catheter is cut to the appropriate length and connected to an external drainage system. This comprehensive approach allows for effective tumor removal while minimizing damage to surrounding brain tissue.