CPT® Code 62146

A cranioplasty is a surgical procedure aimed at repairing a defect in the skull, which may arise from trauma, surgery, or congenital conditions. This specific procedure, coded as CPT® 62146, involves the use of an autograft, meaning that the bone graft is sourced from the patient's own body. The procedure is designed for defects that are up to 5 cm in diameter. During the operation, the area of the skull that has been injured or has a defect is carefully exposed to allow for proper access. If the procedure involves the use of previously removed cranial bone, this bone is retrieved from a subcutaneous pocket, which is a separate reportable procedure. The cranial bone graft is then returned to the defect site and secured in place using various methods such as sutures, wires, or a combination of miniplates and screws to ensure stability and proper healing. In cases where a local bone graft is utilized, a larger piece of bone is harvested from another area of the skull. This involves splitting the bone with a chisel, replacing the cortical bone at the donor site, and subsequently using the inner plate of the donor bone to repair the skull defect. Both the donor site and the defect site are meticulously repaired with sutures or wires to promote healing. Alternatively, bone grafts may also be harvested from other anatomical sites such as the tibia, scapula, ribs, or iliac crest, depending on the specific needs of the patient and the size and shape of the defect. The bone graft is then shaped and configured to fit the defect precisely, ensuring a secure and effective repair. For defects larger than 5 cm, the appropriate code to use is 62147.