2025 CPT code 64585

Revision or removal of peripheral neurostimulator electrode array.

This code is for peripheral nerves, excluding cranial nerves.Do not report this code for removal of temporary leads or for lead replacement.For concurrent removal and replacement, use the appropriate placement code.Use appropriate modifiers (e.g., 50 for bilateral procedures, 78 for return to the operating room) when applicable. Modifier 59 is important if 64585 is performed along with another procedure on the same day.

Modifiers are applicable. Common examples include modifier 50 (bilateral procedure), modifier 78 (unplanned return to the operating room), modifier 22 (increased procedural services) and modifier 59 (distinct procedural service).

Medical necessity must be established by documenting the patient's symptoms, prior treatments, and the rationale for peripheral nerve stimulation revision or removal. If related to infection, documentation of the infection and failed conservative management should be included.

The physician is responsible for surgically exposing the existing electrode array, performing the necessary revisions or removal using microsurgical techniques, and closing the surgical site. The physician must also manage any complications related to the device or procedure.

In simple words: This procedure involves revising or removing the wires (electrode array) of a nerve stimulator implanted under the skin.The nerve stimulator sends electrical impulses to nerves in the body (not in the brain or spinal cord).This procedure is done if the device isn't working correctly or if there's an infection.

This code describes the surgical revision (shortening, redirecting, re-attaching) or removal of a peripherally implanted electrode array (which may include several electrodes) that are part of a neurostimulator system.The neurostimulator system is used to transmit electrical impulses to nerves outside of the brain and spinal cord. The procedure is typically performed due to component malfunction or infection.

Example 1: A patient with a peripheral nerve stimulator for chronic pain experiences lead migration, requiring surgical revision of the electrode array to restore proper function., A patient develops a localized infection around the implanted electrode array, necessitating removal of the affected components., A patient with a peripheral nerve stimulator undergoes surgery to remove the electrode array due to a device malfunction.

Documentation should include the reason for revision/removal (e.g., infection, lead migration, malfunction), operative details, including the approach and techniques used, and any complications encountered.Pre- and post-operative imaging studies, if performed, should also be documented.

** For removal of the associated pulse generator, use 64595. For integrated neurostimulator systems (pulse generator and electrode in one unit) use 64598.

  • Global Days : 10 days
  • Specialties:Neurology, Neurosurgery, Pain Management, Urology
  • Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient
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