2025 CPT code 64583
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Neurostimulator Procedures Surgical Procedures on the Nervous System Feed
Revision or replacement of a hypoglossal nerve neurostimulator array and distal respiratory sensor electrode(s), including connection to an existing pulse generator.
Modifiers 52 (reduced services) can be used if only one component (hypoglossal nerve stimulator OR respiratory sensor) needs revision/replacement. Other modifiers may be applicable depending on the circumstances of the service.
Medical necessity for 64583 is established by the presence of OSA symptoms despite appropriate conservative management. Documentation should support the need for revision or replacement based on clinical findings such as lead displacement, lead malfunction, or failure of the system to effectively treat the sleep apnea. The procedure should be considered medically necessary to improve the patient's respiratory function during sleep.
The clinical responsibility includes surgical access to the hypoglossal nerve, revision or replacement of the hypoglossal nerve neurostimulator electrode array and distal respiratory sensor electrode(s), connection of these components to the existing pulse generator, and testing the functionality of the entire system post-procedure.Pre-operative assessment and post-operative care are also included as part of the global service.
- Surgical Procedures on the Nervous System
- Surgical Procedures on the Nervous System > Neurostimulator Procedures
In simple words: The doctor fixes or replaces parts of a device implanted near the tongue and in the chest to help with sleep apnea. This device helps someone breathe better during sleep. The doctor connects these parts to an existing device already in the body.
This CPT code reports the revision or replacement of a previously implanted hypoglossal nerve neurostimulator electrode array and one or more distal respiratory sensor electrodes.The procedure includes connecting these components to an existing pulse generator. The hypoglossal nerve, which innervates the tongue, is accessed surgically.The electrode array around the nerve and the respiratory sensor electrode(s) (often located lower in the chest) are revised or replaced. Leads from both the neurostimulator array and respiratory sensor are connected to the pulse generator. The system uses the respiratory sensor to monitor breathing, triggering signals from the pulse generator to the hypoglossal nerve electrode array to maintain airway openness during sleep, potentially aiding in sleep apnea treatment. Post-procedure testing is inherent to the service.
Example 1: A patient with obstructive sleep apnea (OSA) who has a previously implanted hypoglossal nerve stimulator experiences lead migration and requires revision of the electrode array. This would be coded as 64583., A patient with OSA has a malfunctioning respiratory sensor electrode.The respiratory sensor and the hypoglossal nerve stimulator electrode array require replacement.This procedure would be coded as 64583., During a routine follow-up, a physician determines the hypoglossal nerve stimulator array requires revision due to displacement, but the respiratory sensor is functioning normally. Modifier 52 would be used in conjunction with 64583 to indicate a reduced service.
Pre-operative diagnosis of OSA, operative report detailing the revision or replacement procedure, including the number of electrodes revised or replaced, type of anesthesia used, and the specifics of the connections made. Post-operative assessment of the system's functionality and verification of correct placement.Imaging studies may also be required to confirm the device's placement.
** This code is specific to revision or replacement of the electrode arrays and sensor leads, not the pulse generator itself.Always confirm the appropriate use of modifiers based on the services performed.Detailed documentation is crucial for appropriate reimbursement.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: Data not available in source.Refer to CMS for current RVU values.
- Global Days : Data not available in source.Global surgical period would need to be determined based on specific payer guidelines and the nature of the procedure performed.
- Payment Status: Active
- Modifier TC rule: Data not available in source.Whether a technical component modifier applies depends on the specific circumstances of the service and payer policies.
- Fee Schedule : Data not available in source.Consult your payer's fee schedule for historical and current payment amounts.
- Specialties:Neurosurgery, Otolaryngology, Sleep Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center