2025 CPT code 63664
(Active) Effective Date: N/A Revision Date: N/A Surgery - Neurostimulators (Spinal) Procedures Surgical Procedures on the Nervous System Feed
Revision, including replacement when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy when performed.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., modifier 22 for increased procedural service, modifier 51 for multiple procedures).Consult the most up-to-date CPT guidelines and local payer policies.
Medical necessity for code 63664 is established by documented evidence of decreased or ineffective stimulation from the existing spinal cord stimulator.This may be due to electrode displacement, breakage, or other malfunction.The revision/replacement surgery is considered medically necessary to restore adequate pain relief and improve the patient's quality of life.
The neurosurgeon or spine surgeon is responsible for performing the surgical revision or replacement of the spinal cord stimulator electrode array. This includes prepping the patient, making the incision, accessing the stimulator components, revising or replacing the electrodes, and closing the wound.Fluoroscopic guidance may be used.
- Surgical Procedures on the Nervous System
- Surgical Procedures on the Nervous System > Neurostimulators (Spinal) Procedures
In simple words: This code covers a surgery to fix or replace parts of a spinal cord stimulator that were put in place during a previous surgery. The doctor may adjust the position of the stimulator parts to improve how well it works.Sometimes, X-ray imaging is used to guide the surgery.
This CPT code 63664 encompasses the surgical revision, and potential replacement, of spinal neurostimulator electrode plates or paddles that were initially implanted via a laminotomy or laminectomy procedure.The revision may involve adjustments to the electrode placement to optimize functionality.Fluoroscopy may be utilized for procedural guidance.This code does not include the initial implantation or removal of the neurostimulator system components; those are coded separately. Replacement of the plates/paddles is included in this code.
Example 1: A patient had a spinal cord stimulator implanted 2 years ago via laminectomy.They experience decreased stimulation effectiveness in the lower lumbar region. The surgeon performs a revision surgery using fluoroscopy to reposition the electrodes, improving stimulation in the target area. Code 63664 is used., A patient's spinal cord stimulator electrode paddle becomes dislodged.The surgeon revises the stimulator implant through a new incision.The procedure includes removal of the dislodged paddle and replacement with a new electrode paddle. Code 63664 is used., During a routine follow-up visit, a patient reports worsening pain and reduced stimulation from their spinal cord stimulator. Imaging reveals that one of the electrode plates is fractured.Surgical revision is performed to replace the damaged plate. Code 63664 is used.
Preoperative imaging (X-ray, CT, MRI) showing the location and condition of the existing stimulator electrodes.Operative report detailing the surgical approach, specifics of the revision or replacement, and confirmation of improved placement/function. Postoperative imaging to confirm the new electrode position.Patient's medical history including prior spinal surgeries.Documentation of the patient's pain levels and functional improvement post-surgery.
** This code is for procedures performed via a laminotomy or laminectomy approach.For percutaneous approaches, refer to other appropriate CPT codes.Always ensure appropriate documentation to justify the medical necessity and support accurate coding.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center