2025 CPT code 62140

Cranioplasty for skull defect; up to 5 cm diameter.

Follow current CPT coding guidelines for surgical procedures.

Modifiers may apply depending on the circumstances of the procedure (e.g., 59 for distinct procedural service, 78 for unplanned return). Refer to the CPT manual for guidance.

Medical necessity for cranioplasty is established when a skull defect poses a risk of brain injury, compromises neurological function, or causes significant cosmetic deformity.The size and location of the defect, the patient's symptoms, and the potential for complications are all factors considered.

The neurosurgeon is responsible for the entire procedure, including patient preparation, anesthesia, skull fixation, craniotomy, bone flap removal and remodeling, reconstruction, and wound closure. They might also be responsible for placing a lumbar drain if necessary.

IMPORTANT For injection procedures related to cerebral angiography, ventriculography, or pneumoencephalography, refer to codes 36100-36218, 61026, 61120, and 61055 respectively.

In simple words: This surgery fixes a hole in the skull.The doctor removes a piece of skull bone, repairs the hole, and puts the bone piece back. This is done for small holes, no bigger than about 2 inches across.

Cranioplasty is a surgical procedure to repair a defect in the skull, typically resulting from a previous operation (such as craniectomy) or injury.The procedure involves removing a portion of skull bone (bone flap) and repairing the defect, which is limited to a diameter of 5 cm or less.The surgeon will create burr holes, remove the bone flap, remodel it if necessary, then replace and secure it using plates, screws, or bone grafts.The scalp is closed with sutures.A lumbar drain may be used to reduce cerebrospinal fluid pressure.

Example 1: A patient sustains a skull fracture in a motor vehicle accident.The fracture creates a 4cm defect. A cranioplasty is performed to repair the defect and protect the brain., A patient undergoes a decompressive craniectomy for brain swelling due to a stroke.Several months later, a cranioplasty is performed to reconstruct the skull and improve cosmesis., A patient experiences post-surgical skull depression after a craniotomy for tumor resection. A cranioplasty is performed to restore the skull's normal contour and minimize the risk of future complications.A custom-made implant might be used.

* Preoperative imaging (CT scan, MRI) showing the skull defect.* Operative report detailing the surgical technique, materials used, and complications (if any).* Postoperative imaging (CT scan) to assess the reconstruction.* Pathology reports (if applicable).* Documentation of medical necessity.

** The size of the skull defect is crucial for correct code selection.For larger defects, other CPT codes may be more appropriate.Consider the use of modifiers to reflect specific aspects of the procedure or services provided.

  • Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
  • RVU: Information not available in source. Consult the official CPT codebook or your payer's fee schedule for RVU values and reimbursement rates.
  • Global Days : Information not available in source.The global period will vary depending on payer and other factors. Consult your payer's guidelines.
  • Payment Status: Active
  • Modifier TC rule: Information not available in source.The application of TC modifiers will depend on payer policies and specific circumstances.
  • Fee Schedule : Information not available in source. Refer to historical CPT fee schedules or your payer's records.
  • Specialties:Neurosurgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital
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