May 29, 2014
What is the correct code to bill for a prefabricated polymethylmethacrylate custom cranial implant greater than 5 cm? I, the neurosurgeon, think the code should be 62141 (Cranioplasty for skull defect; larger than 5 cm diameter), but the plastic surgeon who is co-surgeon on this case thinks 62143 (Replacement of bone flap or prosthetic plate of skull) should be billed. The bone flap was taken off due to infection in the global period. The custom implant was put back out of the global period.
You are correct – the correct code for a new prefabricated cranial implant is 62140 (Cranioplasty for skull defect; up to 5 cm diameter) or 62141 depending on the diameter of the defect. If the original autologous bone flap were being replaced, then 62143 would be appropriate. Alternatively, 62143 would be appropriate if a prefabricated cranial implant were being replaced; but you would use 62140/62141 for the first-time placement of the PMMA implant.