Question:
We have a Neurosurgeon performing a burr hole procedure for a hematoma removal (CPT 61154). After the removal they are placing an ultrasound compatible burr hole cover over the anterior bur hole and a 1.4 cm ultrasound compatible slotted bur hole cover over the posterior burr hole and secured them with 5 mm titanium screws and the Neurosurgeon is wanting the coders to bill out a 62143. Should we be billing both 61154 and 62143 for this surgical case, or is the cover included in 61154? Or is there any situation that it would be appropriate to bill for a physician? For example, if they documented additional reconstructive cranial work beyond decompression alone. Specifically, contouring and preparation of the surrounding calvarium or intentional cranial reconstruction of a skull defect. Can you please provide any information?
Answer:
Thank you for contacting KZA with your question. 62143 describes replacement of bone flap or prosthetic plate of skull and is generally reported with reconstructive cranial procedures. Placement of a fixation/closure device such as a burr hole cover created during a hematoma evacuation appears to be part of the closure/reconstruction of the surgical access site and may not be able to stand alone to meet the requirements of 62143.
If the operative report contains clear documentation of a separate cranioplasty/reconstructive skull repair that goes beyond placement of the burr hole covers, then consideration to 62143 would be appropriate.
*This response is based on the best information available as of 11/05/26.
