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Official Description

Removal of bone flap or prosthetic plate of skull

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 62142 involves the surgical removal of a bone flap or a prosthetic plate that was previously implanted in the skull. This procedure is typically performed to address a defect in the skull that may have resulted from trauma, surgery, or other medical conditions. The term "bone flap" refers to a section of the skull that has been surgically removed and later replaced, while a "prosthetic plate" is an artificial device used to cover a defect in the skull. The removal process begins with the creation of a U-shaped incision over the area where the bone flap or prosthetic plate is located. Following this, a skin flap is elevated to expose the underlying structure. Any external fixation devices, such as wires, miniplates, or screws, that were used to secure the bone flap or plate are carefully removed. The surgeon then utilizes specialized tools, such as a drill or saw, to separate the bone flap or prosthetic plate from the skull. Once removed, the dura mater, which is the protective covering of the brain, is inspected to ensure its integrity. If necessary, a separate procedure may be performed to repair any defects in the skull that remain after the removal of the bone flap or prosthetic plate.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 62142 is indicated for various conditions that necessitate the removal of a previously implanted bone flap or prosthetic plate. These indications may include:

  • Skull Defect Repair: The procedure is performed to address defects in the skull that may have arisen from prior surgical interventions or trauma.
  • Complications from Previous Surgery: Removal may be required due to complications such as infection, malpositioning, or failure of the implanted material.
  • Assessment of Underlying Structures: The procedure allows for the inspection of the dura mater and other underlying structures for any potential issues that may need to be addressed.

2. Procedure

The procedure for the removal of a bone flap or prosthetic plate involves several critical steps, which are detailed as follows:

  • Step 1: The surgeon begins by making a U-shaped incision over the site of the bone flap or prosthetic plate. This incision is strategically placed to provide optimal access to the area requiring intervention.
  • Step 2: Following the incision, a skin flap is elevated to expose the underlying bone flap or prosthetic plate. This step is crucial for ensuring that the surgical field is clear and accessible for the subsequent steps.
  • Step 3: Any external fixation devices, such as wires, miniplates, or screws that were previously used to secure the bone flap or plate, are carefully removed. This step is essential to facilitate the safe removal of the bone flap or prosthetic plate.
  • Step 4: The surgeon then employs a drill, saw, or other specialized devices to separate the bone flap or prosthetic plate from the skull. This step requires precision to avoid damaging surrounding tissues.
  • Step 5: Once the bone flap or prosthetic plate is successfully detached, it is removed from the surgical site. This allows for further evaluation and treatment of the underlying condition.
  • Step 6: After removal, the dura mater is inspected to ensure that it remains intact. This inspection is critical for assessing the health of the protective covering of the brain.
  • Step 7: If a defect in the skull is identified, a separately reportable procedure may be performed to repair the defect, ensuring the integrity and protection of the cranial cavity.

3. Post-Procedure

Post-procedure care following the removal of a bone flap or prosthetic plate includes monitoring for any signs of complications, such as infection or cerebrospinal fluid leaks. Patients may require pain management and should be observed for neurological status changes. Follow-up appointments are essential to assess the healing process and to determine if additional procedures are necessary for skull defect repair. The recovery period may vary depending on the individual patient's condition and the extent of the procedure performed.

Short Descr RMVL B1 FLP/PROSTC PLATE SKL
Medium Descr RMVL BONE FLAP/PROSTHETIC PLATE SKULL
Long Descr Removal of bone flap or prosthetic plate of skull
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 2
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures

This is a primary code that can be used with these additional add-on codes.

62148 Addon Code MPFS Status: Active Code APC C Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
LT Left side (used to identify procedures performed on the left side of the body)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
RT Right side (used to identify procedures performed on the right side of the body)
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2024-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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