Neurosurgery Coding Alert

Reader Question:

Craniotomy and Cranioplasty

Question: When performing a craniotomy followed by a cranioplasty with titanium plates, should I report the latter with 62140-51?

Washington Subscriber  
Answer: Reattachment of the bones using mini-plates, etc., is considered part of the closure and should not be reported separately. The cranioplasty codes may be used, however, if the surgeon reconstructs or replaces a defect of the skull because of damage, excision or other reasons. In such a case, 62140 (cranioplasty for skull defect; up to 5 cm diameter) or 62141 ( larger than 5 cm diameter), depending on the size of the defect, is correctly appended with modifier -51 (multiple procedures) and billed in addition to the craniotomy (61xxx).

-- Clinical and coding expertise for You Be the Coder and Reader Questions  was provided by Eric Sandham, CPC, compliance educator for Central California Faculty Medical Group, a group practice and training facility associated with the University of California at San Francisco in Fresno.
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