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2025 CPT code 61886

Insertion or replacement of a cranial neurostimulator pulse generator or receiver with connection to two or more electrode arrays.

Follow current CPT coding guidelines for neurosurgical procedures.Ensure proper documentation supports the medical necessity and the specific components of the procedure performed.Appropriate modifiers should be used when applicable, based on payer guidelines.

Modifiers may be applicable depending on circumstances (e.g., 51 for multiple procedures, 52 for reduced services, 59 for distinct procedural service).Consult your payer's specific guidelines.

The medical necessity for this procedure is determined based on the patient's neurological condition and response to conservative management.Conditions like Parkinson's disease, essential tremor, dystonia, and other movement disorders may benefit from neurostimulation when medications or other therapies fail to adequately control symptoms.

The neurosurgeon is responsible for the entire procedure, including pre-operative planning, surgical implantation or replacement of the pulse generator and electrode arrays, post-operative care and follow-up.Anesthesiologist may provide anesthesia services (reported separately).Other specialists may participate in neurophysiological mapping (reported separately).

IMPORTANT For single electrode array, use code 61885. For revision or removal of the generator, use code 61888. Codes 64568 and 64569 relate to cranial nerve stimulator electrode array implantation and revision respectively.For electronic analysis and programming, refer to codes 95970, 95976, 95977, 95983, 95984. Note that test stimulation inherent to placement is not separately reported. Microelectrode recording performed by the operating surgeon during implantation is inclusive and not separately reported.

In simple words: The doctor makes a small cut and places or replaces a device under the skin of the chest or arm. This device sends gentle electrical signals to the brain to help with movement problems caused by conditions like Parkinson's disease or multiple sclerosis. The device is connected to wires that go to the brain.

This CPT code describes the surgical procedure involving the insertion or replacement of a cranial neurostimulator pulse generator or receiver, utilizing either direct or inductive coupling.The procedure necessitates connection to at least two electrode arrays, often situated on opposite sides of the brain. This is commonly performed to manage conditions like Parkinson's disease, tremors, or multiple sclerosis, or to address component malfunctions within the existing system.The procedure includes creating or accessing a subcutaneous pocket, tunneling leads, connecting the leads to the generator, testing the functionality, and securing the generator in place.

Example 1: A 65-year-old patient with Parkinson's disease undergoes implantation of a deep brain stimulator (DBS) system. Code 61886 is used for the placement of the pulse generator and connection to bilateral electrode arrays., A 50-year-old patient with essential tremor experiences battery failure in their existing DBS system.Code 61886 is used for the replacement of the pulse generator, maintaining the existing electrode array., A 70-year-old patient with multiple sclerosis receives a new cranial neurostimulator implantation for pain management. This procedure uses code 61886 because it involves multiple electrode arrays and a new generator.

* Preoperative imaging studies (e.g., MRI, CT) demonstrating the need for neurostimulation.* Detailed operative report documenting the approach, placement of leads, connection to generator, and testing of the system.* Intraoperative neurophysiological monitoring reports (if applicable).* Postoperative imaging confirming placement and absence of complications.* Medical necessity documentation supporting the use of neurostimulation for the patient's condition.

** This code is used for both initial implantation and replacement of the pulse generator.Separate codes exist for electrode array placement, revision, and removal.Always confirm appropriate code selection based on the specific procedures performed.

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