How To Use CPT Code 62201

CPT 62201 describes the procedure known as ventriculocisternostomy, specifically the neuroendoscopic method performed on the third ventricle. This article will provide an overview of CPT code 62201, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 62201?

CPT 62201 is used to describe a specific procedure called ventriculocisternostomy, which involves creating an artificial opening in the floor of the third ventricle of the brain to the cisterna magna. This procedure is performed using a neuroendoscopic method, where a small endoscope is used to access the brain, along with stereotactic imaging guidance. The purpose of this procedure is to treat hydrocephalus, specifically noncommunicating hydrocephalus, by allowing cerebrospinal fluid (CSF) to drain inside the patient’s body.

2. Official Description

The official description of CPT code 62201 is: ‘Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method.’ This code is specifically for the neuroendoscopic method of performing ventriculocisternostomy on the third ventricle. It is important to note that for other intracranial neuroendoscopic procedures, different CPT codes should be used (62161 – 62165).

3. Procedure

1. The procedure begins with the provider using stereotactic computed tomography (CT) or magnetic resonance imaging (MRI) to construct a three-dimensional image of the brain. This image is used to plan and direct the procedure.
2. Once the patient is appropriately prepped and anesthetized, the provider makes a small incision in the scalp and creates a burr hole in the skull along the determined trajectory.
3. Using a neuroendoscope, the provider enters the hollow fluid-filled ventricular compartment of the brain. The neuroendoscope provides illumination and magnification to identify the anatomy of the ventricular system.
4. The provider locates and enters the foramen of Monro, which connects the third ventricle with the lateral ventricles. From there, the provider carefully punctures the floor of the third ventricle and opens it, being cautious not to damage nearby critical vascular structures.
5. After creating the opening, the provider moves through it into the cisternal space to ensure that it is open and unobstructed, allowing CSF to flow freely.
6. If necessary, the provider may insert and tunnel a ventricular catheter to an external collection system or insert a shunt through the opening to drain CSF, blood, and debris from the procedure, reducing the chance of occlusion.
7. Once the procedure is complete, the provider achieves hemostasis, removes all instrumentation, closes the cerebral membranes, replaces and secures the bone flap, and closes the scalp in layers with sterile dressings.