How To Use CPT Code 62115

CPT 62115 describes the reduction of a craniomegalic skull without the need for bone grafts or cranioplasty. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 62115?

CPT 62115 can be used to describe the reduction of a craniomegalic skull, which refers to an enlarged skull. This procedure does not involve the use of bone grafts or cranioplasty. It is typically performed on patients, particularly children, who have received late treatment for hydrocephalus.

2. Official Description

The official description of CPT code 62115 is: ‘Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty.’

3. Procedure

1. During the procedure, the provider makes an incision in the scalp and gains access to the skull.
2. They then manipulate and maneuver the bones of the skull to remodel it and ensure symmetry.
3. No bone grafts or cranioplasty are performed as part of this procedure.
4. Finally, the provider sutures the layers of scalp tissue together and covers the wound with a sterile dressing.

4. Qualifying circumstances

CPT 62115 is performed on patients with a craniomegalic skull, which refers to an enlarged skull. This condition is often seen in patients who have received late treatment for hydrocephalus. The procedure does not require the use of bone grafts or cranioplasty.

5. When to use CPT code 62115

CPT code 62115 should be used when a provider performs the reduction of a craniomegalic skull without the need for bone grafts or cranioplasty. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 62115, the provider must document the following information:

• Patient’s diagnosis of craniomegalic skull
• Details of the procedure performed, including the specific techniques used
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 62115, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately report the procedure and any associated services. Consider any additional guidelines or requirements from payers when submitting claims for reimbursement.

8. Historical information

CPT 62115 was added to the Current Procedural Terminology system on January 1, 1991. It has not undergone any updates or changes since its addition. However, it is important to stay updated with any changes or revisions to the code in future code sets.

9. Examples

1. A provider performs the reduction of a craniomegalic skull on a child who received late treatment for hydrocephalus.
2. During the procedure, the provider manipulates the bones of the skull to remodel it and ensure symmetry.
3. No bone grafts or cranioplasty are performed as part of this procedure.
4. The provider sutures the layers of scalp tissue together and covers the wound with a sterile dressing.
5. Another provider performs the reduction of a craniomegalic skull on an adult patient with a history of hydrocephalus.
6. During the procedure, the provider carefully manipulates the bones of the skull to achieve the desired reduction.
7. No bone grafts or cranioplasty are necessary for this particular case.
8. The provider sutures the incision site and applies a sterile dressing to promote healing.
9. A different provider performs the reduction of a craniomegalic skull on a pediatric patient with a congenital skull abnormality.
10. Using precise techniques, the provider successfully reduces the size of the skull without the need for bone grafts or cranioplasty.