Summary & Overview
CPT 62115: Reduction of Enlarged Skull (Craniomegaly)
CPT code 62115 denotes a surgical cranial procedure to reduce an enlarged skull by maneuvering and reshaping cranial bones. Nationally, this code captures interventions for significant cranial deformity or craniomegaly that require operative correction and often involve multidisciplinary perioperative care. Accurate coding of this procedure is important for clinical documentation, appropriate hospital resource allocation, and case-mix reporting.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the common modifiers associated with similar surgical services. The publication summarizes what to expect in coverage and billing workflows across major national payers, highlights common documentation elements that support medical necessity, and outlines where readers can find related code groupings for operative cranial procedures.
This summary is intended for clinicians, coding professionals, and healthcare administrators seeking a national-level reference for CPT code 62115. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 62115 describes a surgical procedure to reduce a craniomegalic (enlarged) skull by maneuvering the bones. The procedure involves repositioning and contouring cranial bones to address skull enlargement.
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Service type: Surgical cranial reconstruction and skull reduction
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Typical site of service: Inpatient hospital or ambulatory surgical center, depending on clinical complexity and perioperative needs
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or young child diagnosed with craniosynostosis or craniomegaly presenting with abnormal head shape, increasing intracranial pressure signs (vomiting, irritability, developmental delay), or progressive skull deformity. The surgical team evaluates imaging (CT head with 3D reconstruction) and multidisciplinary consultations (neurosurgery, plastic surgery, pediatric anesthesia) are completed preoperatively. The procedure described by 62115 involves intraoperative reduction and realignment of enlarged cranial bones to correct skull contour and relieve pressure. The workflow includes preoperative consent and markings, general endotracheal anesthesia, cranial exposure via scalp incision, careful subperiosteal elevation, mobilization and remodeling or repositioning of calvarial bones, hemostasis, fixation as needed, and layered closure. Postoperative care involves monitoring in a pediatric recovery unit or intensive care setting for airway, neurologic status, and pain control, with follow-up imaging and outpatient wound checks and developmental surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or intensity substantially exceeds typical for 62115 due to extensive remodeling or unexpected complexity |