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The procedure described by CPT® Code 62190 involves the creation of a shunt that facilitates the drainage of excess cerebrospinal fluid (CSF) from the subarachnoid or subdural space in the brain. This is a critical intervention for managing conditions that lead to increased intracranial pressure or other complications associated with abnormal CSF accumulation. The shunt is designed to redirect the flow of CSF to the right atrium of the heart, the atrial appendage (auricle), or the jugular vein, thereby alleviating pressure and preventing potential damage to brain tissue. The procedure begins with a curved incision in the scalp, allowing for the creation of a skin flap that provides access to the underlying structures. A burr hole is then made to facilitate the insertion of the shunt. Following this, a second incision is made in the neck to access the jugular vein or common facial vein, which is essential for the placement of the distal catheter. The use of a guidewire and vessel dilator ensures that the catheter can be accurately positioned within the vascular system. The procedure also involves careful manipulation of the dura mater, which is opened using pinhole cautery to allow for the placement of the catheter into the appropriate space. Once the shunt system is established, it is tested to confirm proper function before the distal catheter is tunneled to its final destination, ensuring effective drainage of CSF and maintaining the integrity of the surrounding tissues.
© Copyright 2025 Coding Ahead. All rights reserved.
The creation of a shunt as described in CPT® Code 62190 is indicated for various medical conditions that result in the accumulation of cerebrospinal fluid (CSF) in the subarachnoid or subdural spaces. These conditions may include:
The procedure for creating a shunt involves several critical steps to ensure proper placement and function of the device. Each step is essential for the successful outcome of the intervention.
After the completion of the shunt placement procedure, careful monitoring is essential to ensure that the system is functioning correctly and that there are no complications. Patients may require observation for signs of infection, bleeding, or improper shunt function. Follow-up imaging studies may be necessary to confirm the correct placement of the shunt and to assess for any potential complications. Recovery time can vary based on the individual patient's condition and the complexity of the procedure, but patients are typically advised to avoid strenuous activities during the initial recovery phase. Proper post-operative care and follow-up appointments are crucial for ensuring the long-term success of the shunt and the management of the underlying condition.
| Short Descr | ESTABLISH BRAIN CAVITY SHUNT | Medium Descr | CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR | Long Descr | Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 | 2 - Insertion, replacement, or removal of extracranial ventricular shunt |
| 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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