How To Use CPT Code 62147

CPT 62147 describes the procedure for cranioplasty with autograft, specifically for defects larger than 5 cm in diameter. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 62147?

CPT 62147 is used to describe the surgical repair of a skull bone defect that is larger than 5 cm in diameter. This procedure involves using bone tissue harvested from another part of the patient’s body and transferring it to the cranium to resolve cranial defects caused by depressed skull fractures, congenital abnormalities, tumors, trauma, or disease.

2. Official Description

The official description of CPT code 62147 is: ‘Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter.’

3. Procedure

1. The patient is prepped and anesthetized.
2. A skull fixation device is placed to hold the patient’s head in position during the procedure.
3. A lumbar drain may be inserted to help remove cerebrospinal fluid and allow the brain to relax.
4. An incision is made in the scalp over the skull defect, and the skin and muscles are lifted and folded back.
5. The provider locates the defect and incises the cranium.
6. Bone grafts harvested from another location, such as cranial bone, ribs, ilium, or other areas, are used to repair the defect.
7. If a cranium graft is used, a split graft technique may be employed, where the outer and inner compact layers of the skull are split apart and used to cover the defect and donor site.
8. The grafts are fixed in place using miniplates, screws, and wires.
9. The tissue flap is folded back, and the layers of scalp tissue are sutured together.
10. A sterile dressing is applied to cover the wound.

4. Qualifying circumstances

CPT 62147 is performed when there is a skull bone defect larger than 5 cm in diameter. This defect can be caused by depressed skull fractures, congenital abnormalities, tumors, trauma, or disease. The procedure requires the use of autografts, which are bone tissues harvested from another part of the patient’s body. The provider must assess the patient’s condition and determine the need for cranioplasty with autograft.

5. When to use CPT code 62147

CPT code 62147 should be used when performing cranioplasty with autograft for defects larger than 5 cm in diameter. It is important to accurately measure the size of the defect to determine the appropriate code to report. If the defect is 5 cm or less, CPT code 62146 should be used instead.

6. Documentation requirements

To support a claim for CPT 62147, the provider must document the following information:

• Patient’s diagnosis and the need for cranioplasty with autograft
• Details of the procedure, including the use of bone grafts and the size of the defect
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or techniques used during the surgery
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 62147, ensure that the procedure meets the criteria for a defect larger than 5 cm in diameter. It is important to accurately measure the size of the defect to determine the appropriate code to report. There are no specific guidelines regarding reporting CPT 62147 with other codes. However, it is important to follow any payer-specific guidelines and modifiers that may be required for accurate billing.

8. Historical information

CPT 62147 was added to the Current Procedural Terminology system on January 1, 1991. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes cranioplasty with autograft for a skull bone defect resulting from a depressed skull fracture larger than 5 cm in diameter.
2. A provider performs cranioplasty with autograft for a patient with a congenital abnormality causing a cranial defect larger than 5 cm in diameter.
3. A patient with a tumor in the skull undergoes cranioplasty with autograft to repair the resulting defect larger than 5 cm in diameter.
4. A provider performs cranioplasty with autograft for a patient with a traumatic cranial defect larger than 5 cm in diameter.
5. A patient with a cranial defect resulting from a disease undergoes cranioplasty with autograft to repair the defect larger than 5 cm in diameter.
6. A provider performs cranioplasty with autograft for a patient with a depressed skull fracture resulting in a cranial defect larger than 5 cm in diameter.
7. A patient with a congenital abnormality causing a cranial defect larger than 5 cm in diameter undergoes cranioplasty with autograft.
8. A provider performs cranioplasty with autograft for a patient with a tumor in the skull resulting in a cranial defect larger than 5 cm in diameter.
9. A patient with a traumatic cranial defect larger than 5 cm in diameter undergoes cranioplasty with autograft.