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The procedure described by CPT® Code 62225 involves the replacement or irrigation of a ventricular catheter, which is a medical device used to drain cerebrospinal fluid (CSF) from the ventricles of the brain. This procedure is typically indicated when a ventricular catheter becomes obstructed or malfunctions, potentially leading to increased intracranial pressure or other complications. The process begins with the insertion of a needle into the catheter tubing to irrigate it, which may help to clear any blockages. If initial attempts to aspirate and irrigate the catheter do not resolve the issue, the catheter must be replaced. This involves making a skin incision over the site of the malfunctioning catheter, disconnecting it from the shunt valve, and using a guidewire to facilitate the removal of the old catheter and the insertion of a new one. The new catheter is then secured and connected to the valve component, ensuring proper function and drainage of CSF. This procedure is critical for maintaining the normal flow of cerebrospinal fluid and preventing complications associated with catheter malfunction.
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The procedure associated with CPT® Code 62225 is indicated for the following conditions:
The procedure begins with the identification of the obstructed or malfunctioning ventricular catheter. The first step involves the insertion of a needle into the catheter tubing to attempt irrigation. This may include an aspiration phase, where the clinician tries to dislodge any small obstructing particles that may be causing the blockage. If this initial attempt is unsuccessful, a second needle is inserted to facilitate simultaneous irrigation and aspiration, aiming to clear the obstruction. Should these methods fail to resolve the issue, the procedure progresses to catheter replacement. A skin incision is made directly over the malfunctioning catheter to gain access. The proximal end of the catheter is then disconnected from the shunt valve, allowing for the next step. A guidewire is inserted into the proximal catheter and carefully advanced into the ventricle. This guidewire serves as a pathway for the removal of the old catheter; it is pulled out over the guidewire. Following this, a new catheter is advanced into the ventricle using the guidewire, ensuring proper placement. Once the new catheter is in position, the guidewire is removed, and the new catheter is secured and connected to the valve component, completing the procedure.
After the completion of the procedure, the patient is typically monitored for any signs of complications, such as infection or improper drainage. The site of the incision may require care to promote healing and prevent infection. Patients may also be observed for changes in neurological status, as the proper functioning of the ventricular catheter is crucial for maintaining normal cerebrospinal fluid dynamics. Follow-up appointments may be scheduled to assess the effectiveness of the new catheter and to ensure that it is functioning correctly.
| Short Descr | REPLACE/IRRIGATE CATHETER | Medium Descr | RPLCMT/IRRIGATION VENTRICULAR CATHETER | Long Descr | Replacement or irrigation, ventricular catheter | 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) | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 2 | CCS Clinical Classification | 2 - Insertion, replacement, or removal of extracranial ventricular shunt |
This is a primary code that can be used with these additional add-on codes.
| 62160 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (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). | 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. | 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. | 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). | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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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