2025 CPT code 64581
(Current) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement).
Modifiers such as 22 (increased procedural services), 50 (bilateral procedure), 59 (distinct procedural service), 78 (return to the operating room), and others may be applicable depending on the circumstances.
Medical necessity must be established for this procedure. This typically involves documentation of failed conservative treatments, such as medication, physical therapy, and behavioral modifications. The patient's symptoms and their impact on quality of life should be clearly documented.
The surgeon is responsible for the entire procedure, including incision, placement of the electrode array, connection to a pulse generator (if present), testing, and wound closure.Preoperative and postoperative care are also part of the surgeon's responsibilities.
In simple words: The surgeon implants a device with small wires (electrode array) near your sacral nerve in your lower back. This is done through an incision in your lower back. The wires are placed through a natural opening in your sacrum (transforaminal placement).This device can help control bladder or bowel function or chronic pelvic pain. Sometimes, a separate device (pulse generator) is implanted under the skin in the buttock or abdomen to send mild electrical pulses to the nerves.
This procedure involves the open implantation of a neurostimulator electrode array into the sacral nerve through a transforaminal approach.The surgeon makes an incision in the lower back to access the sacral nerve. The electrode array, consisting of multiple contacts, is then placed through the sacral foramen.The array may be connected to a pulse generator at this time.The surgeon may test the placement and function of the array before closing the incision.
Example 1: A patient with urinary incontinence that has not responded to conservative treatments undergoes open implantation of a sacral nerve neurostimulator electrode array to improve bladder control., A patient with fecal incontinence undergoes implantation of a neurostimulator electrode array after failing conservative management. The transforaminal approach is used due to patient anatomy., A patient with chronic pelvic pain who has not found relief with other treatments undergoes open placement of a sacral nerve neurostimulator electrode array to manage their pain.
Documentation should include the diagnosis, medical necessity for the procedure, surgical approach used, type of electrode array placed, connection to pulse generator (if applicable), intraoperative testing results, and any complications encountered.
- Global Days : 90 days