Neurosurgery Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.



Question: When charging for a craniotomy, what is the correct code for the replacement of the skull flap with titanium plates and screws?

Gina Kelly
Hot Springs, Ariz.


Answer: Bill CPT 2000 code 62143 (replacement of bone flap or prosthetic plate of skull), recommends Rhonda Petruziello, CPC, reimbursement specialist for neurosurgery at Cleveland Clinic Foundation in Cleveland. This is a procedure that usually is planned or staged and would require a -58 modifier (staged or related procedure or service by the same physician during the postoperative period) if it is performed within the 90-day global period of the primary procedure. The operative reports for both surgeries should indicate clearly that this was a planned procedure to ensure maximum reimbursement from the carrier. If the -58 modifier is not appended and the surgery is performed within 90 days of the primary surgery, it is likely that the carrier will reduce or even deny this code.

Note: If the replacement of the bone flap is at the initial craniotomy, this would be included in the charge for the craniotomy as part of the closure.