2025 CPT code 64569
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Revision or replacement of a cranial nerve (e.g., vagus nerve) neurostimulator electrode array, including connection to an existing pulse generator.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural services, 78 for unplanned returns to the operating room).
Medical necessity for this procedure is established when there is evidence of malfunction, infection, or other complications related to the implanted vagus nerve stimulator electrode array that impairs its function or poses a risk to the patient's health. The documentation must justify the need for revision or replacement rather than other less invasive management strategies.
The neurosurgeon or a qualified specialist in peripheral nerve stimulation is responsible for performing this procedure. This includes pre-operative assessment, surgical technique, post-operative care, and ensuring the proper functioning of the device.
In simple words: The doctor replaces or fixes a device implanted near a nerve in the neck (often the vagus nerve) that helps stimulate the nerve. This is usually done if the device is malfunctioning or infected.
This procedure involves the replacement or revision of a cranial nerve neurostimulator electrode array and its connection to a pre-existing pulse generator.The procedure is typically indicated due to malfunction, infection, or other complications related to the implanted device.The surgeon locates the electrode array around the cranial nerve (often the vagus nerve) within the carotid sheath. The existing lead is disconnected from the generator, and the electrode array is carefully dissected from the nerve.The surgeon may adjust the existing electrodes or replace the entire array, potentially repositioning new electrodes on the nerve. A new array (if applicable) is attached, the lead is tunneled subcutaneously to the generator, and the connection is re-established. The system is thoroughly tested, the generator secured, and the incision closed.
Example 1: A 55-year-old male patient with epilepsy experiences malfunction of his vagus nerve stimulator electrode array. The array is revised using 64569., A 60-year-old female patient develops an infection at the site of her vagus nerve stimulator. The infected electrode array is removed and replaced with a new one using 64569., A 48-year-old patient with chronic pain receives a vagus nerve stimulator implant. During the initial implantation, the electrode array is found to be malpositioned and requires revision using 64569.
* Preoperative diagnosis and indication for the procedure.* Operative report detailing the surgical approach, technique, and findings.* Intraoperative images (if applicable).* Postoperative assessment of the device's functionality.* Pathology report (if applicable).
** This code should only be used for the replacement or revision of the electrode array, not the pulse generator itself.Always refer to the most current CPT manual and payer specific guidelines for accurate coding practices. Ensure that the documentation clearly supports the medical necessity for the procedure.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not provided in the source data and would require access to a specific fee schedule database.
- Global Days : The global period for this procedure would need to be determined based on the specific payer and their guidelines. It is not explicitly stated in the provided information.
- Payment Status: Active
- Modifier TC rule: The information provided does not specify whether a Technical Component (TC) modifier applies.
- Fee Schedule : Historical fee schedule data is not available in the provided information. This requires access to a fee schedule database.
- Specialties:Neurosurgery, Neurological Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center