How To Use CPT Code 62120

CPT 62120 describes the repair of an encephalocele, specifically focusing on the skull vault and including 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 62120?

CPT 62120 is used to describe the surgical repair of an encephalocele, specifically addressing the defect or gap in the cranial vault and correcting any associated skull deformities. This code is utilized when a healthcare provider performs a procedure to repair the part of the brain that extends through the defect and restores the integrity of the skull.

2. Official Description

The official description of CPT code 62120 is: ‘Repair of encephalocele, skull vault, including cranioplasty.’

3. Procedure

1. The healthcare provider begins by making an incision in the scalp to expose the area around the cerebral herniation.
2. Next, the protruding cerebral tissue is carefully separated from the scalp tissue, minimizing blood loss.
3. A bone flap, known as a craniotomy, is created by making one or more burr holes in the skull using a surgical drill.
4. The provider then uses a craniotome, a special surgical saw, to remove the bone flap and access the encephalocele.
5. Any nonfunctional cerebral tissue is removed, and the brain tissue, as well as any membranes or fluids that have come out of the gap in the skull, are carefully returned to their proper position.
6. The sac surrounding the encephalocele is removed, and the damaged dura, the outermost layer surrounding the brain, is closed with sutures.
7. A synthetic graft or tissue sealant, such as fibrin glue, may be applied over the dural suture line to ensure a watertight seal.
8. The bone flap is then replaced, and the skull is closed using plates, wires, and screws as necessary.
9. The layers of scalp tissue are sutured together, and the wound is covered with a sterile dressing.

4. Qualifying circumstances

CPT 62120 is performed on patients with an encephalocele, which is a herniation or protrusion of part of the brain through a defect in the skull. This defect can be congenital, traumatic, or postsurgical in nature. The procedure is typically carried out by a qualified healthcare provider who has the necessary expertise in repairing skull vault defects and performing cranioplasty.

5. When to use CPT code 62120

CPT code 62120 should be used when a healthcare provider performs the repair of an encephalocele involving the skull vault and cranioplasty. It is important to note that this code is specific to the repair of encephaloceles and should not be used for other procedures or conditions.

6. Documentation requirements

To support a claim for CPT 62120, the healthcare provider must document the following information:

• Patient’s diagnosis of an encephalocele
• Description of the repair procedure performed, including details of the skull vault defect and cranioplasty
• Date of the procedure
• Any additional findings or complications encountered during the surgery
• Details of the closure technique used, including the use of synthetic grafts or tissue sealants
• Any post-operative instructions or recommendations
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 62120, it is important to ensure that the procedure performed aligns with the description of the code. The healthcare provider should also verify that the procedure is not already included in another bundled service. Additionally, it is crucial to follow any specific billing guidelines provided by the payer or insurance company to ensure accurate reimbursement.

8. Historical information

CPT 62120 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone no updates or changes since its addition. However, it is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A neurosurgeon performing a repair of an encephalocele involving the skull vault and cranioplasty for a patient with a congenital defect.
2. A plastic surgeon conducting a procedure to repair an encephalocele in the skull vault and perform cranioplasty for a patient who experienced a traumatic injury.
3. A pediatric neurosurgeon performing a repair of an encephalocele involving the skull vault and cranioplasty for a patient who underwent previous surgical intervention.
4. A craniofacial surgeon conducting a procedure to repair an encephalocele in the skull vault and perform cranioplasty for a patient with a complex skull deformity.
5. A neurosurgeon performing a repair of an encephalocele involving the skull vault and cranioplasty for a patient with a postsurgical defect.
6. A reconstructive surgeon conducting a procedure to repair an encephalocele in the skull vault and perform cranioplasty for a patient with a congenital defect and associated skull deformity.
7. A neurosurgeon performing a repair of an encephalocele involving the skull vault and cranioplasty for a patient with a traumatic injury and skull deformity.
8. A pediatric neurosurgeon conducting a procedure to repair an encephalocele in the skull vault and perform cranioplasty for a patient who underwent previous surgical intervention and has a complex skull deformity.
9. A craniofacial surgeon performing a repair of an encephalocele involving the skull vault and cranioplasty for a patient with a postsurgical defect and associated skull deformity.