How To Use CPT Code 62180

CPT 62180 describes the placement of a shunt to move cerebrospinal fluid from a brain ventricle to the cisterna magna. 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 62180?

CPT 62180 can be used to describe the surgical procedure in which a shunt is placed to redirect cerebrospinal fluid from a brain ventricle to the cisterna magna. This code is used when the provider creates an incision in the scalp, makes a burr hole in the skull, and tunnels the shunt catheter under the scalp towards the neck. The provider then exposes the first cervical vertebra, enlarges the hole at the base of the skull, and inserts the shunt catheter tip into the subarachnoid space. The procedure is performed to alleviate the buildup of cerebrospinal fluid in the brain ventricles.

2. Official Description

The official description of CPT code 62180 is: ‘Ventriculocisternostomy (Torkildsen type operation)’. This procedure involves the placement of a shunt catheter to redirect cerebrospinal fluid from a brain ventricle to the cisterna magna.

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made in the scalp, and a burr hole is created in the skull to access the target brain ventricle.
3. A shunt catheter is placed in the lateral ventricle, and the other end of the catheter is tunneled under the scalp towards the neck.
4. The provider exposes the first cervical vertebra and enlarges the hole at the base of the skull, known as the foramen magnum.
5. Part of the first cervical vertebra is removed, and the dura, the outer membrane covering the brain, is split.
6. The shunt catheter tip is inserted into the subarachnoid space, which is located under the arachnoid mater, one of the brain’s protective membranes.
7. The provider closes the dura, followed by the muscles, fascia, and scalp. Dressings are applied to the incision site.

4. Qualifying circumstances

CPT 62180 is performed in patients with a buildup of cerebrospinal fluid in the brain ventricles. The procedure is indicated when other treatment options have been ineffective in managing the condition. The patient must be appropriately prepped and anesthetized, and the provider must have the necessary expertise to perform the procedure.

5. When to use CPT code 62180

CPT code 62180 should be used when a provider performs the ventriculocisternostomy procedure to redirect cerebrospinal fluid from a brain ventricle to the cisterna magna. This code should not be used for other procedures or interventions unrelated to cerebrospinal fluid shunting.

6. Documentation requirements

To support a claim for CPT 62180, the provider must document the following information:

• Patient’s diagnosis and the need for cerebrospinal fluid shunting
• Details of the procedure, including the incision site, burr hole placement, and shunt catheter insertion
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Post-operative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 62180, ensure that the procedure meets the criteria for medical necessity and is appropriately documented. It is important to use the correct CPT code for the specific procedure performed. CPT code 62180 should not be reported with other codes unless there are distinct and separate procedures performed during the same operative session.

8. Historical information

CPT 62180 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A neurosurgeon performs a ventriculocisternostomy procedure to redirect cerebrospinal fluid in a patient with hydrocephalus.
2. A pediatric neurologist performs a ventriculocisternostomy to alleviate the buildup of cerebrospinal fluid in a child with congenital aqueductal stenosis.
3. A neurosurgeon performs a ventriculocisternostomy with fenestration of the fourth ventricle in a patient with obstructive hydrocephalus.
4. A neurosurgeon performs a ventriculocisternostomy with choroid plexus cauterization in a patient with communicating hydrocephalus.
5. A neurosurgeon performs a ventriculocisternostomy with choroid plexus fenestration in a patient with normal pressure hydrocephalus.
6. A neurosurgeon performs a ventriculocisternostomy with choroid plexus papilloma resection in a patient with a symptomatic choroid plexus papilloma.
7. A neurosurgeon performs a ventriculocisternostomy with removal of a cyst in a patient with a cystic brain lesion causing hydrocephalus.
8. A neurosurgeon performs a ventriculocisternostomy with removal of a tumor in a patient with a brain tumor causing obstructive hydrocephalus.
9. A neurosurgeon performs a ventriculocisternostomy to alleviate the buildup of cerebrospinal fluid in a patient with a history of traumatic brain injury.