CPT® Code 61600

The CPT® Code 61600 refers to the surgical procedure involving the resection or excision of neoplastic, vascular, or infectious lesions located at the base of the anterior cranial fossa, specifically in an extradural context. This procedure is performed through a separately reported approach to access the anterior fossa. The surgical technique involves a lateral to medial resection or excision, during which the cribriform plate is carefully examined for any lesions. If lesions are found to involve the cribriform plate, osteotomies are performed to remove the plate en bloc along with the surrounding pathological tissue, while making every effort to preserve critical structures such as the olfactory bulb, cranial nerves, and blood vessels. In cases where further exploration is necessary, the sinus may be examined, and additional procedures such as rhinotomy, ethmoidectomy, maxillectomy, or maxillotomy may be performed as dictated by the surgical findings. If the dura mater can remain intact during the procedure, it is retracted to facilitate access to the underlying structures, and a drill or chisel is utilized to excise the bone as needed to complete the resection. Should the lesion extend into the dural space, the procedure involves dividing the dural sleeves along the olfactory nerves, opening the dura, and performing further excision of the lesion. Post-excision, the dural defect is repaired using sutures or graft materials, such as autologous pericranium or synthetic materials, to ensure a watertight seal and prevent cerebrospinal fluid leakage. The extradural defect is typically filled with autologous graft material, and the skull defect is closed using the patient’s own bone, cadaver bone graft, or a metal plate, with the incision being sutured in layers, and the skin may be closed with staples.