Cerebellopontine Angle Surgery

Question:

I did a posterior fossa craniectomy for resection of a cerebellopontine angle tumor requiring the dura to be repaired with a synthetic graft and reconstruction of the cranial defect with a titanium mesh cranioplasty. I know I will use 61520 for the tumor removal. Can I use 62140 for the cranioplasty? What about 15769 for the synthetic graft? Lastly, I was told I could also use 15733 for the flap closure.

Answer:

OK, we agree with 61520 for the primary procedure. Reconstruction of the defect with titanium mesh is considered the “usual” closure so you would not also code 62140 (or 62141). CPT 15769 is for excision of an autologous graft, such as abdominal fat, so you could not use this code for a synthetic graft. In fact, there is no separate coding for repairing the dura with a synthetic graft – it is part of the primary procedure code, 61520. Lastly, 15733 for the muscle flap would also not be used for a “flap closure” as this also was part of the usual closure.

*This response is based on the best information available as of 04/21/22.