Summary & Overview
CPT 62200: Ventriculocisternostomy for Hydrocephalus
CPT code 62200 denotes a ventriculocisternostomy — a neurosurgical procedure that creates an opening in the floor of the third ventricle to permit cerebrospinal fluid (CSF) drainage into the cisterna magna. This procedure addresses hydrocephalus, most often noncommunicating forms, by restoring physiologic CSF pathways and avoiding or supplementing shunt dependency. Nationally, procedures coded under 62200 are clinically significant because they involve high-acuity operative care, specialized neurosurgical teams, and resource-intensive perioperative management.
Key payers discussed include 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 service type, and which major payers commonly cover or adjudicate claims for this neurosurgical intervention. The publication also outlines common modifiers associated with the code and summarizes what to expect in billing practice, coding considerations, and areas where policy updates or payer-specific rules may affect claim processing. This summary is intended for coding professionals, revenue cycle staff, and clinical managers seeking a national-level briefing on CPT code 62200 and its operational implications.
Billing Code Overview
CPT code 62200 describes a ventriculocisternostomy, a neurosurgical procedure that creates an artificial opening in the floor of the third ventricle to connect cerebrospinal fluid (CSF) flow to the cisterna magna. This operation is performed to treat hydrocephalus, most commonly noncommunicating hydrocephalus, by allowing CSF to drain internally within the patient’s central nervous system.
Service type: Neurosurgical intracranial CSF diversion procedure
Typical site of service: Operating room or specialized neurosurgical suite in an inpatient or hospital outpatient setting
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents with progressive headache, gait instability, and intermittent nausea. Brain MRI demonstrates obstructive (noncommunicating) hydrocephalus due to aqueductal stenosis with enlarged lateral and third ventricles and periventricular transependymal flow. The neurosurgeon evaluates the patient and recommends an endoscopic third ventriculostomy (ETV) to create an outflow from the third ventricle to the subarachnoid space, avoiding shunt dependence.
Preoperative workflow includes neurosurgical evaluation, informed consent, neuroimaging review, anesthesia assessment, and perioperative antibiotic prophylaxis. The procedure is performed in an operating room under general anesthesia with endoscopic equipment. Postoperative workflow includes immediate neurologic assessment, head CT or MRI as indicated, inpatient observation for CSF leak or infection, and discharge planning with outpatient neurosurgical follow-up for wound check and monitoring of symptom resolution.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard procedure code (no modifier) | Use when no modifier applies and service is billed as primary. |
11 | Primary procedure |