2025 CPT code 62147
Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Cranioplasty with autograft, larger than 5 cm diameter.
Modifiers may apply depending upon the circumstances. Common modifiers include 22 (Increased Procedural Services), 51 (Multiple Procedures), 59 (Distinct Procedural Service), etc.
Medical necessity must be established by documenting the underlying cause of the skull defect and its impact on the patient's health and function. The chosen repair method must be justified as medically appropriate for the specific defect.
The surgeon is responsible for prepping the patient, placing the fixation device and lumbar drain (if necessary), making the incision, harvesting the bone graft, repairing the defect, securing the graft, closing the incision, and applying a sterile dressing.
In simple words: A surgery to repair a large hole in the skull (larger than 5cm) using bone taken from another part of the patient's body. The surgeon makes an incision, lifts the skin and muscle, repairs the skull defect with the bone graft, secures it, and closes the incision.
Repair of a skull bone defect exceeding 5 cm in diameter using a bone graft harvested from the patient. This procedure addresses cranial defects caused by depressed skull fractures, congenital abnormalities, tumors, or other trauma or disease.The procedure involves prepping and anesthetizing the patient, placing a skull fixation device, and potentially inserting a lumbar drain. An incision is made in the scalp, the skin and muscles are lifted, the defect is located, and the cranium is incised.Bone grafts are harvested, often using a split graft technique where a section of the skull is resected, split into layers, and used to cover the defect and donor site. The grafts are fixed with miniplates, screws, and wires. The scalp tissue is sutured, and the wound is dressed.
Example 1: A patient with a 6 cm skull defect resulting from a depressed skull fracture undergoes cranioplasty with an autograft harvested from the rib., A child with a congenital skull defect larger than 5 cm undergoes cranioplasty with an autograft from the ilium., A patient who had a tumor removed from the skull, resulting in a 7cm defect, undergoes cranioplasty with an autograft harvested using the split graft technique from another area of their skull.
Documentation should include the size of the skull defect, the location of the bone graft harvest site, the method of graft fixation, and any complications encountered.
- Specialties:Neurosurgery, Plastic Surgery, Craniofacial Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center