Neurosurgery Coding Alert

Question: What CPT® should be used when the doctor brings back the patient a month after craniotomy to do a cranioplasty with the bone saved as graft?

New York Subscriber

Answer: Your scenario does not describe how you saved the bone graft. Presumably, the original craniotomy flap was placed in a subcutaneous abdominal pocket for later retrieval. In that circumstance, you would report 62143 (Replacement of bone flap or prosthetic plate of skull) as well as the add-on code for bone graft retrieval 62148 (Incision and retrieval of subcutaneous cranial bone graft for cranioplasty [List separately in addition to code for primary procedure]). Since this is performed one month after the craniotomy and falls within that global period, you would report both codes appended with the 58 (Staged or related procedure or service by the same physician during the postoperative period) modifier for staged surgery.