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2025 CPT code 64590

Insertion or replacement of a peripheral, sacral, or gastric neurostimulator pulse generator or receiver requiring pocket creation and connection to the electrode array.

Follow all applicable AMA CPT® coding guidelines.

Modifiers may apply depending on the circumstances of the service. Consult the CPT® codebook and payer-specific guidelines for appropriate modifier usage.

Medical necessity is established through documentation of a specific diagnosis and failure of conservative treatment options. This will demonstrate that the neurostimulator is a necessary and appropriate treatment for the patient's condition.

The surgeon is responsible for the entire surgical procedure, including incision, pocket creation, lead placement, connection to the pulse generator or receiver, and wound closure.Post-operative care and programming may be handled by other qualified personnel.

IMPORTANT Do not report 64590 with 64595, 64596, 64597, or 64598. For percutaneous electrode array with integrated neurostimulator, use 64596. For neurostimulators without a named target nerve (e.g., field stimulation), use 64999.

In simple words: The doctor puts in or replaces a device that sends electrical signals to nerves to help with pain or other problems.This involves making a small cut to create a space for the device and connecting it to wires that stimulate the nerves.

This CPT code encompasses the insertion or replacement of a peripheral, sacral, or gastric neurostimulator pulse generator or receiver.The procedure necessitates surgical creation of a pocket for implant placement and establishing a connection between the electrode array and the pulse generator or receiver.It involves incising the skin at the implantation site, creating or revising a pocket, connecting the leads from the electrode array to the generator/receiver, and closing the incision. Test stimulations may be performed to verify system functionality.This code is not used with 64595, 64596, 64597, or 64598.

Example 1: A patient with chronic lower back pain undergoes implantation of a peripheral nerve stimulator. Code 64590 is used to report the insertion of the pulse generator., A patient with overactive bladder symptoms has a sacral nerve stimulator implanted.Code 64590 is used to report the insertion of the pulse generator., A patient with gastric motility disorder requires replacement of their existing gastric neurostimulator pulse generator. Code 64590 is used to report the replacement procedure.

** The code describes procedures involving a system with a detachable connection between the electrode array and the pulse generator or receiver.If the system is integrated, codes 64596-64598 should be used instead.

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