How To Use CPT Code 62220

CPT 62220 describes the creation of a shunt to drain excess cerebrospinal fluid (CSF) from the ventricles of the brain to the atria, jugular veins, or auricular processes. 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 62220?

CPT 62220 can be used to describe the creation of a shunt, or tube, that allows for the drainage of excess cerebrospinal fluid (CSF) from the ventricles of the brain to other parts of the body. This procedure is typically performed to treat conditions such as hydrocephalus, where the ventricles of the brain become enlarged due to an accumulation of CSF. The shunt can be directed towards the atria, jugular veins, or auricular processes, depending on the specific needs of the patient.

2. Official Description

The official description of CPT code 62220 is: ‘Creation of shunt; ventriculo-atrial, -jugular, -auricular.’

3. Procedure

1. The procedure begins with the provider making an incision in the scalp and pulling it back to expose the skull.
2. A burr hole is then drilled into the skull, allowing access to the ventricles of the brain.
3. The provider inserts the shunt into the ventricles, creating a pathway for the excess CSF to drain.
4. The end of the shunt is directed towards the chosen drainage site, which can be the atria, jugular veins, or auricular processes.
5. If necessary, the provider may suture the shunt into place to ensure its stability.
6. Finally, the scalp is closed in layers to complete the procedure.

4. Qualifying circumstances

CPT 62220 is typically performed on patients with conditions such as hydrocephalus, where the ventricles of the brain become enlarged due to an accumulation of cerebrospinal fluid (CSF). The procedure is performed by a qualified healthcare professional and may involve the use of an endoscope to assist in the placement of the shunt. The specific drainage site, whether it be the atria, jugular veins, or auricular processes, is determined based on the individual patient’s needs.

5. When to use CPT code 62220

CPT code 62220 should be used when a healthcare professional performs the creation of a shunt to drain excess cerebrospinal fluid (CSF) from the ventricles of the brain. This code is appropriate for cases where the shunt is directed towards the atria, jugular veins, or auricular processes. It is important to note that CPT code 62220 should not be used for intracranial neuroendoscopic ventricular catheter placement, which has its own specific code (62160).

6. Documentation requirements

To support a claim for CPT code 62220, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for the creation of a shunt
• Specific drainage site chosen (atria, jugular veins, or auricular processes)
• Date of the procedure
• Details of the procedure, including the incision, burr hole drilling, shunt insertion, and closure of the scalp
• Any additional relevant information, such as the use of an endoscope
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 62220, ensure that the procedure involves the creation of a shunt to drain excess cerebrospinal fluid (CSF) from the ventricles of the brain. The specific drainage site (atria, jugular veins, or auricular processes) should be documented. It is important to note that CPT code 62220 should not be reported with CPT codes 62160 or any other codes related to intracranial neuroendoscopic ventricular catheter placement.

8. Historical information

CPT code 62220 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone a Medicare change in 2017, where it was added to the Inpatient Only (IPO) list.

9. Examples

1. A neurosurgeon performing the creation of a ventriculo-atrial shunt to drain excess cerebrospinal fluid (CSF) from the ventricles of the brain in a patient with hydrocephalus.
2. A neurologist creating a ventriculo-jugular shunt to alleviate the symptoms of a patient with normal pressure hydrocephalus.
3. A pediatric surgeon performing the creation of a ventriculo-auricular shunt to treat a child with congenital hydrocephalus.
4. A neurosurgeon creating a ventriculo-atrial shunt to drain excess CSF in a patient with pseudotumor cerebri.
5. A neurologist performing the creation of a ventriculo-jugular shunt to manage the symptoms of a patient with post-traumatic hydrocephalus.
6. A pediatric surgeon creating a ventriculo-auricular shunt to treat a child with Dandy-Walker syndrome.
7. A neurosurgeon performing the creation of a ventriculo-atrial shunt to drain excess CSF in a patient with arachnoid cyst.
8. A neurologist creating a ventriculo-jugular shunt to alleviate the symptoms of a patient with normal pressure hydrocephalus.
9. A pediatric surgeon performing the creation of a ventriculo-auricular shunt to treat a child with congenital hydrocephalus.