2025 CPT code 64597

Insertion or replacement of each additional percutaneous peripheral nerve electrode array with an integrated neurostimulator, including imaging guidance, at the same session as the initial procedure (64596).

This is an add-on code and should only be reported in conjunction with 64596. Imaging guidance is inherent and should not be separately reported.

Modifiers 22 (increased procedural services), 51 (multiple procedures), and others may apply depending on the circumstances of the procedure.

Medical necessity is established by clinical documentation demonstrating the need for additional electrode arrays beyond the initial array implanted to achieve optimal therapeutic effect for symptom relief. This may include anatomical limitations, insufficient coverage with the initial array, or spread of symptoms requiring additional targeted stimulation.

The physician is responsible for percutaneous insertion or replacement of the additional electrode array, including imaging guidance, ensuring proper placement to stimulate the target peripheral nerve, and closure of the incision.

IMPORTANT This code is used in conjunction with 64596.It should not be used with 64555, 64561, 64590, or 64595. For percutaneous implantation of only the electrode array, use 64555. For trial or permanent electrode arrays or pulse generators for peripheral subcutaneous field stimulation, use 64999. For neurostimulators without a named target nerve (e.g., field stimulation), use 64999. For percutaneous implantation or replacement of integrated neurostimulation system for bladder dysfunction, posterior tibial nerve, use 0587T. For open implantation or replacement of integrated neurostimulator system, posterior tibial nerve, see 0816T, 0817T.

In simple words: This code is for adding extra electrode arrays when a doctor puts in or replaces a device to stimulate a peripheral nerve.It only applies if the doctor is also doing the main procedure of putting in the first electrode array during the same visit.

This code reports the percutaneous insertion or replacement of each additional peripheral nerve electrode array with an integrated neurostimulator during the same session as the initial procedure (CPT code 64596).The procedure includes imaging guidance.This is an add-on code and must be reported with 64596.It does not include the initial electrode array placement. For replacement, the previously implanted electrode array is removed before insertion of the new system. Imaging guidance is inherent to this procedure and should not be separately reported.

Example 1: A patient presents for implantation of a peripheral nerve stimulator. The surgeon inserts the initial array (64596) and, due to the patient's anatomy, needs to add a second array for optimal coverage. Code 64597 is used to bill for the second array., A patient with a previously implanted peripheral nerve stimulator requires revision due to lead migration. The old array is removed, and a new, larger array is implanted along with an additional array for better coverage. Code 64597 is used to report the placement of the additional array in conjunction with 64596 or 64598 (for revision)., A patient undergoes implantation of a peripheral nerve stimulator. The initial array (64596) is placed, and a second array is placed at a different nerve branch to treat additional symptoms.64597 is used for the additional array.

Operative report detailing the procedure, including the number of additional electrode arrays placed, imaging guidance used, and placement confirmation.Preoperative and postoperative assessments noting the indication for additional arrays and location of the arrays.Patient consent form.

** This code is specific to percutaneous placement and does not apply to open surgical approaches.The definition of "additional" implies more than one electrode array is placed during the same session, where the first array is reported using code 64596.The location of the additional array(s) should be clearly documented.

  • Revenue Code: P6C (Minor Procedures - Other)
  • Global Days : This is an add-on code; the global period is determined by the primary procedure (64596).
  • Payment Status: Active
  • Modifier TC rule: Not applicable.
  • Specialties:Neurosurgery, Pain Management, Neurology
  • Place of Service:Office, Ambulatory Surgical Center, Hospital Outpatient
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