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Sample Format for Required CPT® Clinical Vignettes

Current Procedural Terminology (CPT®)

61863 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array

Typical patient:

A 66-year-old woman presents with a ten-year history of idiopathic Parkinson's disease that has caused progressive disability. She continues to respond to antiparkinson medications, however; her symptoms are no longer adequately controlled with medications and she is experiencing disability for many activities of daily living. Medication adjustments and different medication regimens have failed to improve her level of disability.

Description of procedure(s)/service(s):

She undergoes implantation of a stereotactically-guided deep brain stimulator electrode array in the subthalamic nucleus using macro stimulation for targeting and confirmation of electrode placement.

57425 Laparoscopy, surgical, colpopexy (suspension of vaginal apex)

Typical patient:

A 63-year-old sexually active G5P5 underwent abdominal hysterectomy twenty years ago for leiomyomata. She developed a symptomatic cystocele and rectocele and was treated with anterior and posterior repair 3 years ago. Now she is being evaluated for pelvic and vaginal pressure-like discomfort and tissue prolapsing through the introitus. Examination documents prolapse of the vaginal vault through the introitus and good anterior and posterior support. A colpopexy is required.

Description of procedure(s)/service(s):

Laparoscopy, surgical, colpopexy (suspension of vaginal apex) is performed.

37765 Stab phlebectomy of varicose veins, one extremity; 10 – 20 stab incisions, (For less than 10 use 37999) (For more than 20 incisions, use 37766)

Typical patient:

A 70-year-old man with a lifelong history of slowly enlarging left lower extremity varicose veins complains of pain and heaviness in the leg when trying to participate in the daily exercise routine recommended by his PCP. He has failed a trial of medical-grade graduated compression stockings.

Description of procedure(s)/service(s):

Stab phlebectomy is performed.