CPT® Code 61892

The procedure described by CPT® Code 61892 involves the removal of a skull-mounted cranial neurostimulator pulse generator or receiver, which is a device implanted in the skull to manage conditions such as drug-resistant focal epilepsy. This procedure is typically indicated when there is a malfunction of the device, complications arise, or the patient experiences intolerance to the therapy provided by the neurostimulator. The removal process is performed under general anesthesia to ensure the patient's comfort and safety. The surgical team reopens the scalp flap that covers the generator, carefully maneuvering the muscle and underlying tissues to access the device. If cranioplasty is necessary, which may occur if the removal of the device has compromised the integrity of the skull, a bone graft or synthetic material—such as calcium phosphate or hydroxyapatite—is utilized to fill the void left by the device. This material is secured in place using titanium plates or mesh. Alternatively, a customized implant made from materials like polymethyl methacrylate or polyetheretherketone may be used to restore the skull's structure. After the skull has been adequately repaired, the muscle tissue is repositioned over the skull, and the scalp flap is sutured back into place, completing the procedure.