CPT® Code 63707

The procedure described by CPT® Code 63707 involves the repair of a dural or cerebrospinal fluid (CSF) leak that does not require a laminectomy. A CSF leak typically occurs when there is a tear or laceration in the spinal meninges, which are the protective membranes surrounding the spinal cord. This condition can arise from various causes, including trauma or complications from previous surgical procedures on the spine. When the meninges are compromised, it can lead to the formation of a cutaneous fistula, where the fluid leaks out through the skin, or it may seep into surrounding soft tissues without creating an external opening. In some instances, a fibrous capsule may develop in the soft tissue surrounding the leak. If the dura mater is torn but the arachnoid layer remains intact, it can lead to a condition known as pseudomeningocele, where the arachnoid herniates through the dural tear. The procedure coded as 63707 specifically addresses the repair of these leaks without the need for laminectomy, which is a surgical procedure that involves the removal of a portion of the vertebra to access the spinal cord. The repair process typically follows a diagnostic imaging procedure to accurately locate the leak, after which an incision is made over the affected area of the spine to facilitate the repair using nonabsorbable sutures and possibly fibrin sealant to ensure a watertight closure.