CPT® Code 62220

The procedure described by CPT® Code 62220 involves the creation of a shunt that facilitates the drainage of excess cerebrospinal fluid (CSF) from the brain. This is typically achieved by placing a shunt from the lateral ventricle of the brain to various potential drainage sites, including the right atrium of the heart, the atrial appendage (auricle), or the jugular vein. The procedure begins with a curved incision in the scalp, allowing for the creation of a skin flap that provides access to the underlying structures. A burr hole is then made in the skull using a perforator, followed by the perforation of the dura mater with pinhole cautery to access the ventricular system. To establish a pathway for the shunt, a second incision is made in the neck to access the jugular vein or common facial vein. A needle is inserted into the selected vein, and a guidewire along with a vessel dilator is introduced to facilitate the placement of the shunt catheter. The catheter is carefully advanced through the brain's layers, including the pia mater, gray and white matter, and ependymal lining, until it is positioned within the lateral ventricle. Once the catheter is in place, it is connected to a shunt valve, which is tested to ensure proper CSF flow. If the system is functioning correctly, the distal catheter is tunneled from the head into the neck, with careful advancement through the subgaleal space and the superficial muscles of the neck. The distal end of the catheter may either terminate in the jugular vein or be advanced further to terminate in the right atrium or atrial appendage. This procedure is critical for managing conditions associated with excess cerebrospinal fluid, thereby preventing complications such as increased intracranial pressure.