CPT® Code 61512

The procedure described by CPT® Code 61512 involves a craniectomy, trephination, and bone flap craniotomy specifically for the excision of a meningioma located in the supratentorial region of the brain. The supratentorial area is defined as the portion of the brain situated above the tentorium cerebelli, which is a fold of the dura mater that separates the cerebrum's frontal and occipital lobes from the cerebellum. A craniectomy is a surgical procedure that entails the creation of scalp flaps, followed by the drilling of burr holes in the skull. The bone between these burr holes is then meticulously cut using a surgical saw or craniotome, allowing for the elevation and removal of a bone flap, which may be done temporarily or permanently. Trephination is a technique that involves the excision of a circular section of the skull, while craniotomy refers to the broader process of creating both scalp and bone flaps to gain access to the brain region affected by the tumor. In contrast to CPT® Code 61510, which pertains to the excision of brain tumors or lesions other than meningiomas, CPT® Code 61512 specifically targets meningiomas, which are tumors arising from the meninges—the protective membranes covering the brain and spinal cord. Meningiomas are typically slow-growing and benign, although malignant variants can occur, albeit infrequently. During the procedure, the meningioma is exposed, and the blood vessels supplying it are identified and coagulated to prevent excessive bleeding. The tumor is then completely resected, including any affected dura mater and any hyperostotic bone. Following the excision, the dura is repaired using either an autograft from the pericranium or fascia lata, or a synthetic dural substitute may be employed. The final steps involve repairing the skull defect, reapproximating the scalp flap, and closing the skin incision, ensuring a thorough and careful approach to the surgical site.