2025 CPT code 64596

Percutaneous insertion or replacement of an initial peripheral nerve electrode array with an integrated neurostimulator; includes imaging guidance.

Refer to the official CPT guidelines for neurostimulator procedures and for add-on codes.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., 22 for increased procedural services, 51 for multiple procedures, 78 for unplanned return to the OR).Consult the CPT guidelines for specific modifier usage rules.

Medical necessity for code 64596 would be established by documentation of a patient’s chronic intractable neuropathic pain not adequately controlled by other treatments. The procedure should provide a reasonable expectation of pain relief and improvement in quality of life.Payer-specific criteria may vary.

The physician prepares the patient, makes a small incision, inserts or replaces the integrated neurostimulation system, confirms proper placement using imaging, and closes the incision.For replacements, the old system is removed first.

IMPORTANT +64597 (add-on code for each additional electrode array inserted or replaced during the same session); 64598 (revision or removal of the electrode array with integrated neurostimulator)

In simple words: The doctor inserts or replaces a device that stimulates a peripheral nerve through a small skin opening. This device is all in one unit and includes imaging to ensure proper placement. This is for the first or only device inserted.

This CPT code encompasses the percutaneous insertion or replacement of the initial electrode array for a peripheral nerve with an integrated neurostimulator.The procedure includes imaging guidance.This code is for the first or only electrode array inserted or replaced during a session.The integrated system comprises the electrode array and receiver, eliminating the need for a separate pulse generator.

Example 1: A patient with chronic neuropathic pain in their lower extremity undergoes percutaneous placement of a new integrated peripheral nerve neurostimulator system. Code 64596 is used to report the initial electrode array insertion., A patient with a malfunctioning integrated peripheral nerve neurostimulator undergoes a replacement procedure.The old system is removed, and a new one is placed. Code 64596 reports the initial electrode array replacement., A patient requires two electrode arrays implanted during the same surgical session. Code 64596 is used for the first array and +64597 for the second array.

Preoperative diagnosis, operative report detailing the procedure, including imaging guidance used (if any), type of device implanted, and postoperative course.Patient consent forms, anesthesia records, and any relevant imaging studies.

** This code is for percutaneous procedures only.Open surgical approaches would require different codes. The use of imaging guidance is inherent to this code and should not be separately reported.Always check for NCCI edits and payer-specific policies.

  • Revenue Code: P6C (MINOR PROCEDURES - OTHER)
  • Payment Status: Active
  • Modifier TC rule: Not applicable.This is a comprehensive code encompassing the entire procedure.
  • Specialties:Neurosurgery, Pain Management, Orthopedics
  • Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department
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