CPT® Code 62148

Add-On Code

1. Indications

The procedure associated with CPT® Code 62148 is indicated for patients who require a cranioplasty due to a skull defect. This may arise from various conditions, including but not limited to traumatic injuries, congenital defects, or previous surgical interventions that have resulted in a loss of cranial bone integrity. The retrieval of the subcutaneous cranial bone graft is essential for the successful repair of these defects, ensuring that the patient can regain structural support and protection for the brain.

• Skull Defect Repair The procedure is performed to address defects in the skull that may compromise the protection of the brain.
• Traumatic Injuries Patients who have sustained injuries leading to cranial bone loss may require this procedure for reconstruction.
• Congenital Defects Individuals born with skull abnormalities may benefit from the use of a bone graft for corrective surgery.
• Previous Surgical Interventions Past surgeries that have resulted in cranial bone loss necessitate the retrieval of grafts for effective repair.

2. Procedure

The procedure begins with the identification of the previous incision site on the patient's scalp, where the subcutaneous pocket containing the cranial bone graft is located. The surgeon carefully makes an incision along this site to minimize additional trauma to the surrounding tissues. Once the incision is made, the subcutaneous pocket is opened, allowing access to the stored bone graft. The surgeon then meticulously locates the graft within the pocket, ensuring that it is freed from any surrounding tissue that may have adhered to it over time. This step is crucial to prevent damage to the graft, which is vital for its subsequent use in cranioplasty. After the graft is successfully retrieved, it is placed in an antibiotic solution to maintain its viability and prevent infection until it is needed for the cranioplasty procedure. Following the retrieval, the surgeon irrigates the subcutaneous pocket thoroughly to cleanse the area of any debris or contaminants. Hemostasis is then achieved using electrocautery, which effectively controls any bleeding that may occur during the procedure. Finally, the skin pocket is closed with sutures or staples, completing the incision and retrieval process.

• Step 1: The surgeon identifies and opens the previous incision site to access the subcutaneous pocket.
• Step 2: The cranial bone graft is located and carefully freed from surrounding tissue.
• Step 3: The retrieved graft is placed in an antibiotic solution for preservation.
• Step 4: The subcutaneous pocket is irrigated to ensure cleanliness.
• Step 5: Hemostasis is achieved using electrocautery to control bleeding.
• Step 6: The skin pocket is closed to complete the procedure.

3. Post-Procedure

After the procedure, the patient is monitored for any signs of complications, such as infection or excessive bleeding. The surgical site may require regular dressing changes to maintain cleanliness and promote healing. Patients are typically advised on post-operative care, including activity restrictions to avoid strain on the incision site. Follow-up appointments are essential to assess the healing process and to prepare for the subsequent cranioplasty procedure, where the retrieved bone graft will be utilized. The overall recovery time may vary depending on the individual patient's health status and the complexity of the initial condition being treated.