CPT® Code 62145

A cranioplasty for skull defect with reparative brain surgery is a surgical procedure aimed at repairing a defect or injury in the skull while simultaneously addressing underlying brain issues. This procedure is typically performed when there is a need to correct a skull injury or defect that has occurred due to trauma, disease, or surgical intervention. During the operation, the area of the skull that has been damaged is carefully exposed to allow for direct access. If a temporary prosthetic plate has been previously placed over the defect, it is removed to facilitate the repair process. The specific reparative procedure that follows is determined by the nature of the brain injury being treated, which may involve various techniques depending on the clinical scenario. Once the reparative work on the brain is completed, the focus shifts to repairing the skull defect. If the original cranial bone has been preserved, it can be retrieved from a subcutaneous pocket where it may have been stored, and then reattached to the skull using sutures, wires, or a combination of miniplate and screws for stability. In cases where a local bone graft is utilized, a larger piece of bone is harvested from another area of the skull, split, and then used to fill the defect while ensuring that the donor site is also repaired. Alternatively, bone grafts can be sourced from other anatomical locations such as the tibia, scapula, ribs, or iliac crest, and are shaped to fit the defect precisely. The graft is then secured in place using similar fixation methods. In some instances, a prosthetic plate may be employed instead of bone grafting, which is also secured with wires or miniplate and screws. Finally, the soft tissue and skin over the surgical site are meticulously closed in layers to promote healing and restore the integrity of the scalp.