2025 CPT code 64582

Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array.

For revision or replacement of either the hypoglossal nerve stimulator electrode array or distal respiratory sensor, use modifier 52 and bill at a reduced rate.For removal of one or two components, also use modifier 52 and bill at a reduced rate.

Modifiers may be applicable, such as modifier 52 for reduced services.

Medical necessity for this procedure is established by documentation of moderate to severe OSA, failure of conservative treatment modalities, and appropriate patient selection criteria based on established guidelines.

The physician is responsible for the entire surgical procedure, including patient preparation, anesthesia, incisions, placement of the electrode array, pulse generator, and respiratory sensor, connecting the components, testing the device, and wound closure.

IMPORTANT For revision or replacement of the hypoglossal nerve stimulator, use 64583. For removal, use 64584. For replacement of the pulse generator alone, use 61886.

In simple words: This procedure helps people with sleep apnea breathe better during sleep.A small device is implanted that stimulates the nerve controlling the tongue. This stimulation moves the tongue forward, preventing it from blocking the airway. A sensor is also implanted to monitor breathing and coordinate the stimulation with each breath.

This procedure involves the open implantation of a hypoglossal nerve neurostimulator array, a pulse generator, and a distal respiratory sensor electrode or electrode array.It is used to treat obstructive sleep apnea (OSA). The hypoglossal nerve, which controls tongue movement, is stimulated to keep the airway open during sleep. The procedure involves making incisions to access the hypoglossal nerve and create a pocket, often in the chest, for the pulse generator. The electrode array is placed around the nerve, and a lead is tunneled subcutaneously from the electrodes to the generator. A respiratory sensor electrode is also placed, typically lower in the chest, and connected to the pulse generator. This sensor monitors breathing and triggers the stimulator to activate the hypoglossal nerve, moving the tongue forward and maintaining airway patency.

Example 1: A patient with moderate to severe OSA, who has not responded to conservative treatments, undergoes implantation of a hypoglossal nerve stimulator., A patient with a previous hypoglossal nerve stimulator implant requires revision or replacement of the device due to malfunction or lead migration., A patient experiences complications from their hypoglossal nerve stimulator, necessitating removal of the device.

Documentation should include the diagnosis of OSA, medical necessity for the procedure, details of the surgical procedure, including placement and connection of components, device settings, and postoperative testing results. Preoperative studies, such as sleep studies and imaging, should also be documented.

  • Payment Status: Active
  • Specialties:Otolaryngology, Sleep Medicine, Surgery
  • Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital
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