CPT® Code 61518

Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull

The procedure described by CPT® Code 61518 involves a craniectomy specifically for the excision of a brain tumor located in the infratentorial region or posterior fossa of the brain. This area is situated below the tentorium cerebelli and encompasses critical structures such as the cerebellum and brainstem. A craniectomy is a surgical intervention where a portion of the skull is removed to access the brain. The process begins with the creation of scalp flaps, which allows the surgeon to gain access to the underlying bone. Burr holes are drilled into the skull, and the bone between these holes is then cut using a specialized saw or craniotome. The resulting bone flap can be elevated and removed, either temporarily or permanently, to facilitate the surgical procedure. In this specific case, the focus is on excising a brain tumor or lesion that is not classified as a meningioma, cerebellopontine angle tumor, or a midline tumor at the base of the skull. The surgical approach includes incising the dura mater, the protective membrane covering the brain, and creating a dural flap to provide access to the tumor. An operative microscope is utilized to enhance visualization, allowing the surgeon to identify and preserve vital cortical blood vessels and other critical structures during the dissection of the tumor from the surrounding brain tissue. The goal of the procedure is to achieve complete resection of the tumor; however, if the tumor is closely associated with critical structures, the surgeon will excise as much of the tumor as is safely possible. This meticulous approach is essential to minimize damage to surrounding healthy brain tissue while effectively addressing the tumor. The procedure is distinct from other related codes, such as CPT® Code 61519, which pertains specifically to the excision of meningiomas, highlighting the unique considerations and techniques involved in the surgical management of different types of brain tumors.