CPT® Code 61618

Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)

The procedure described by CPT® Code 61618 involves a secondary repair of the dura mater, which is the outermost layer of the protective covering of the brain and spinal cord. This repair is specifically indicated for cases where there is a leakage of cerebrospinal fluid (CSF) from the anterior, middle, or posterior cranial fossa. Such leaks may occur following surgical interventions on the skull base, including tumor resections or repairs of vascular lesions, when the initial closure of the dura has proven inadequate. The secondary repair utilizes a free tissue graft, which can be sourced from various tissues such as pericranium, fascia, or tensor fascia lata, or may involve adipose tissue, homologous grafts, or synthetic materials. The graft is meticulously shaped and positioned over the area of the dural deficit, and it is secured in place to create a watertight seal, thereby preventing further CSF leakage. This procedure is critical in ensuring the integrity of the central nervous system and preventing complications associated with CSF leaks, such as infection or neurological deficits.