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A cranioplasty is a surgical procedure aimed at repairing a defect in the skull, which may occur due to trauma, surgery, or congenital conditions. In this specific procedure, designated by CPT® Code 62147, the repair is performed using an autograft, meaning that the bone graft is sourced from the patient's own body. The procedure is indicated for skull defects that exceed 5 cm in diameter. During the operation, the area of the skull that has been injured or has a defect is carefully exposed to allow for proper access. If the procedure involves the use of previously removed cranial bone, this bone is retrieved from a subcutaneous pocket, which is a separate reportable procedure. The cranial bone graft is then returned to the defect site and secured in place using various methods such as sutures, wires, or a combination of miniplates and screws to ensure stability and proper healing. In cases where a local bone graft is utilized, a larger piece of bone is harvested from another area of the skull, split with a chisel, and the cortical bone is replaced at the donor site. The defect is then repaired using the inner plate of the donor bone, with both the donor and defect sites being secured with sutures or wires. Alternatively, bone grafts may also be harvested from other anatomical sites such as the tibia, scapula, ribs, or iliac crest, and are shaped to fit the specific dimensions of the skull defect. This procedure is critical for restoring the integrity of the skull and protecting the underlying brain tissue.
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The cranioplasty procedure using CPT® Code 62147 is indicated for the following conditions:
The procedure for cranioplasty with autograft involves several critical steps to ensure effective repair of the skull defect.
Post-procedure care for patients undergoing cranioplasty with autograft includes monitoring for any signs of complications such as infection or hematoma formation. Patients may require pain management and should be advised on activity restrictions to promote healing. Follow-up appointments are essential to assess the integrity of the graft and the overall recovery process. The expected recovery time may vary based on individual patient factors and the extent of the procedure.
| Short Descr | CRNOP W/AUTOGRAFT>5 CM DIAM | Medium Descr | CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER | Long Descr | Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter | 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 | 1 | 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) |
| 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. | 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). | 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. | 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. | 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. | 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.) | 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 | 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) |
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| 2024-01-01 | Changed | Short Description changed. |
| 1991-01-01 | Added | First appearance in code book in 1991. |
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