How To Use CPT Code 62190

CPT 62190 describes the insertion of a shunt to drain fluid from the subarachnoid or subdural space to the atrial chamber, jugular vein, or auricle of the heart. 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 62190?

CPT 62190 is used to describe the procedure of inserting a shunt to drain fluid from the subarachnoid or subdural space to the atrial chamber, jugular vein, or auricle of the heart. This code is used when a buildup of fluid under the arachnoid or dural membrane covering the brain requires drainage through the insertion of a shunt.

2. Official Description

The official description of CPT code 62190 is: ‘Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the scalp to access the fluid collection in the subarachnoid or subdural space.
3. A burr hole is created in the skull to allow access to the fluid.
4. The shunt is inserted into the space and subcutaneously tunneled towards the drain site.
5. A venous catheter is placed and used to maneuver the shunt to the atrial chamber, jugular vein, or auricle of the heart.
6. The provider ensures that the catheter functions properly to drain the fluid.
7. The brain membranes are sutured, and the surgical wounds are closed.

4. Qualifying circumstances

CPT 62190 is performed in patients with a buildup of fluid under the arachnoid or dural membrane covering the brain. The procedure involves the insertion of a shunt to drain the fluid to the atrial chamber, jugular vein, or auricle of the heart. The patient must meet the clinical criteria for this procedure, and the provider must determine the necessity for shunt insertion based on the patient’s condition.

5. When to use CPT code 62190

CPT code 62190 should be used when a patient requires the insertion of a shunt to drain fluid from the subarachnoid or subdural space to the atrial chamber, jugular vein, or auricle of the heart. This code is appropriate for cases where the buildup of fluid cannot be managed through other means and requires surgical intervention.

6. Documentation requirements

To support a claim for CPT 62190, the provider must document the following information:

• Patient’s diagnosis and the need for shunt insertion
• Details of the procedure, including the specific location of the shunt insertion and the drain site
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 62190, ensure that the procedure meets the necessary criteria for shunt insertion. Use the appropriate CPT code based on the specific location of the shunt insertion and the drain site. It is important to follow the specific guidelines provided by the payer to ensure accurate and appropriate billing.

8. Historical information

CPT 62190 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.

9. Examples

1. A patient with subarachnoid fluid buildup undergoes the insertion of a shunt to drain the fluid to the atrial chamber of the heart.
2. A provider performs the insertion of a shunt to drain subdural fluid to the jugular vein in a patient with a dural membrane disorder.
3. Auricular shunt insertion is performed in a patient with a buildup of fluid in the subarachnoid space.
4. A provider inserts a shunt to drain fluid from the subdural space to the atrial chamber in a patient with a traumatic brain injury.
5. A patient with hydrocephalus undergoes the insertion of a shunt to drain fluid from the ventricles to the jugular vein.
6. A provider performs the insertion of a shunt to drain subarachnoid fluid to the auricle of the heart in a patient with a congenital condition.
7. A patient with a subdural hematoma undergoes the insertion of a shunt to drain fluid to the atrial chamber of the heart.
8. A provider performs the insertion of a shunt to drain fluid from the subarachnoid space to the jugular vein in a patient with a chronic condition.
9. Auricular shunt insertion is performed in a patient with a buildup of fluid in the subdural space.
10. A provider inserts a shunt to drain fluid from the subarachnoid space to the atrial chamber in a patient with a brain tumor.