Summary & Overview
CPT 62142: Removal of Bone Flap or Prosthetic Skull Plate
CPT code 62142 denotes the surgical removal of a previously placed bone flap or prosthetic skull plate and is used when implants must be taken out because of infection, swelling, wound-healing problems, or tumor regrowth. This code captures a clinically significant neurosurgical procedure that can affect hospital resource use, length of stay, and postoperative care needs across inpatient and outpatient surgical settings. Nationally, accurate use of this code matters for tracking complication-related returns to the operating room and for appropriate claims processing.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and typical sites of service, plus national benchmarking context and coding and billing considerations relevant to payers listed above. The publication outlines common clinical scenarios prompting explantation of cranial hardware and summarizes what stakeholders need to know about claim classification and potential utilization impacts. Data not available in the input will be noted where applicable.
This resource is intended for coding professionals, revenue cycle staff, clinical leaders, and policy analysts seeking clear, national-level context about CPT code 62142 and its role in neurosurgical care and claims processing.
Billing Code Overview
CPT code 62142 describes the surgical removal of a previously placed bone flap or prosthetic skull plate. This procedure is performed when the implant or bone flap must be taken out because of infection, swelling, wound-healing complications, or tumor regrowth.
Service type: Surgical — Craniotomy/Cranial Implant Removal
Typical site of service: Hospital operating room or ambulatory surgical center (inpatient or outpatient surgical setting depending on clinical status)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who previously underwent a craniotomy with placement of an autologous bone flap or prosthetic skull plate and now presents with complications requiring removal. Common presenting features include a nonhealing scalp wound with exposed hardware, purulent drainage, localized scalp erythema and tenderness, fever, or imaging evidence of osteomyelitis or deep-seated infection involving the bone flap or plate. The clinical workflow begins with outpatient or emergency evaluation, targeted laboratory testing (CBC, inflammatory markers), wound cultures, and contrasted CT or MRI to assess the flap and adjacent intracranial structures. Neurosurgery evaluates the patient and documents indication for removal (infection, wound healing problem, elevated intracranial pressure from swelling, or tumor regrowth). Preoperative optimization includes antibiotics directed by culture when available, informed consent describing risks of removing the bone flap or prosthesis and potential need for staged reconstruction, and coordination with anesthesia. The procedure is performed in an operating room under general anesthesia. Intraoperative steps include scalp incision and exposure, careful dissection to avoid dural injury, removal of the prosthesis or bone flap, debridement of infected tissue, copious irrigation, possible collection of intraoperative cultures, and wound closure with or without drain placement. Postoperative care includes targeted IV antibiotics, wound checks, imaging as indicated, and planning for future cranioplasty if clinically appropriate. Typical site of service is hospital inpatient or ambulatory surgery center depending on acuity; most cases for infection or wound breakdown are performed as inpatient procedures due to need for IV antibiotics and monitoring.
Coding Specifications
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