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Official Description

Replacement 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 62143 involves the replacement of a bone flap or a prosthetic plate in the skull. This surgical intervention is typically performed to address defects or injuries to the cranial structure. The process begins with the exposure of the site where the skull injury or defect is located. If the original cranial bone, which may have been previously removed due to trauma or surgical necessity, is available, it is retrieved from a subcutaneous pocket. This retrieval is considered a separately reportable procedure. Once the bone graft is prepared, it is carefully returned to the defect site and secured in place using various methods such as sutures, wires, or a combination of miniplate and screws to ensure stability and proper alignment. In cases where the original bone flap is not available or suitable for reattachment, a prosthetic plate can be utilized as an alternative. The surgeon selects an appropriately sized prosthetic plate, which is then secured to the skull using similar fixation techniques. After the bone or plate is in place, the overlying soft tissue and skin are meticulously repaired in layers to promote optimal healing and restore the integrity of the cranial structure.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 62143 is indicated for various conditions that result in defects or injuries to the skull. These may include:

  • Skull Fractures: Traumatic injuries that lead to fractures in the cranial bones, necessitating repair to restore structural integrity.
  • Post-Surgical Defects: Areas of the skull that require reconstruction following neurosurgical procedures, where bone flaps may have been removed for access to the brain.
  • Congenital Defects: Birth-related anomalies that affect the shape or structure of the skull, which may require surgical intervention to correct.
  • Infection or Osteomyelitis: Conditions that lead to bone loss or damage due to infection, requiring replacement of the affected bone with either the original bone flap or a prosthetic plate.

2. Procedure

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

  • Step 1: The surgical site is prepared, and the area of the skull injury or defect is exposed through an incision. This allows the surgeon to access the underlying bone structure directly.
  • Step 2: If a previously removed cranial bone flap is available, it is retrieved from a subcutaneous pocket where it was stored. This step is crucial for cases where the original bone can be reused, as it helps maintain the natural anatomy of the skull.
  • Step 3: The retrieved cranial bone graft is then carefully positioned back into the defect site. The surgeon ensures that the bone is aligned correctly to restore the skull's contour and function.
  • Step 4: The bone flap is secured in place using various fixation methods, which may include sutures, wires, or a combination of miniplate and screws. This stabilization is essential to promote healing and prevent displacement of the graft.
  • Step 5: In instances where the original bone flap is not suitable for reattachment, a prosthetic plate is selected based on the size and shape required to effectively cover the defect. The plate is then secured to the skull using similar fixation techniques.
  • Step 6: After the bone or prosthetic plate is securely in place, the overlying soft tissue and skin are repaired in layers. This meticulous closure is important for optimal healing and to minimize complications such as infection or scarring.

3. Post-Procedure

Post-procedure care following the replacement of a bone flap or prosthetic plate involves monitoring the surgical site for signs of infection, ensuring proper healing, and managing any discomfort. Patients may be advised to limit physical activity during the initial recovery phase to prevent strain on the surgical site. Follow-up appointments are typically scheduled to assess the healing process and to remove any sutures or staples if necessary. Additionally, imaging studies may be performed to confirm the proper placement and integration of the bone flap or prosthetic plate within the skull.

Short Descr RPL B1 FLP/PROSTC PLATE SKL
Medium Descr RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL
Long Descr Replacement 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) 1 - Co-surgeons could be paid, though supporting documentation is required...
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)
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).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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.
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.
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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).
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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).
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
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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