2025 CPT code 64570

Removal of cranial nerve (e.g., vagus nerve) neurostimulator electrode array and pulse generator.

Code 64570 is used only when both the electrode array and pulse generator are removed without replacement. For procedures involving replacement or revision of components, other codes are applicable.

Modifiers may be applicable to further specify the circumstances of the procedure (e.g., increased procedural services, bilateral procedure, etc.).

Medical necessity for removal must be clearly documented. This could include evidence of infection, lack of therapeutic benefit, or intolerable side effects. Documentation should support that conservative management options were tried if applicable, and that removal is the most appropriate course of action for the patient's well-being.

The physician's responsibility includes locating and removing the electrode array from the vagus nerve within the carotid sheath. This requires meticulous dissection, often using microsurgical techniques under magnification to avoid nerve damage. The physician also removes the pulse generator and closes the surgical incisions.

IMPORTANT For replacement of a vagal nerve peripheral neurostimulator pulse generator, consider codes 61885 and 61886 depending on whether a single or bilateral electrode array is being replaced. Do not report 64570 in conjunction with 61888.

In simple words: The doctor removes a device implanted under the skin that stimulates a nerve in the neck (vagus nerve) to treat certain conditions. This involves removing both the wires that stimulate the nerve and the battery pack that powers them. It's usually done if there's an infection or the device isn't working as expected.

This procedure involves the removal of a cranial nerve neurostimulator electrode array and its associated pulse generator.The procedure is performed when both the electrode array and pulse generator are removed without being replaced, often due to infection, lack of patient response to treatment, or intolerance to the device. The electrode array, typically placed around the left vagus nerve within the carotid sheath, along with its lead and the existing electronic pulse generator pack, are removed.The procedure usually involves making incisions through the scars from the previous implantation surgery, disconnecting the lead from the generator, and carefully dissecting the electrodes from the nerve using microsurgical techniques under magnification.The existing generator pack is then removed, and the incisions are closed with sutures and/or tissue adhesive.

Example 1: A patient with a vagus nerve stimulator develops a persistent infection at the implant site that doesn't respond to antibiotics, necessitating removal of the device (electrode array and pulse generator)., A patient with a vagus nerve stimulator experiences no improvement in their condition after an appropriate trial period, and the decision is made to remove the device (electrode array and pulse generator)., A patient with a vagus nerve stimulator develops intolerable side effects from stimulation, requiring the complete removal of the device (electrode array and pulse generator).

Documentation should include the reason for the removal, operative details (including the location of incisions, method of electrode removal, and confirmation of complete removal of both array and generator), and any complications encountered during the procedure.Prior imaging studies may be included to assist in locating the implanted devices.

** As of 2024, this code is no longer valid.iFrameAI can provide information on the most current codes for neurostimulator removal procedures. Always ensure to consult the most up-to-date coding resources when submitting claims.

  • Revenue Code: P1G - Major Procedure - Other
  • Payment Status: Invalid
  • Specialties:Neurosurgery, Otolaryngology
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.