© Copyright 2025 American Medical Association. All rights reserved.
Vagus nerve blocking (VBLOC) therapy is a medical procedure designed to assist in the treatment of morbid obesity. The vagus nerve, also known as the pneumogastric nerve or cranial nerve X, originates from the brainstem and consists of two branches that extend along the esophagus, bronchi, and major blood vessels, passing through the diaphragm and terminating in the upper part of the stomach. This nerve plays a crucial role in the regulation of hunger and satiety by transmitting signals between the stomach and the brain. In VBLOC therapy, a specialized technique is employed where an intermittent, high-frequency, low-energy electrical stimulus is applied to block the nerve impulses that communicate hunger signals from the stomach and pancreas to the brain. This interruption aims to help patients manage their appetite and, consequently, their weight. The procedure involves the surgical removal of the pulse generator, which is a component of the VBLOC system, and may include repositioning or replacing electrode arrays that are implanted near the vagus nerve. The overall goal of this therapy is to provide a non-pharmacological option for individuals struggling with severe obesity, thereby improving their health outcomes and quality of life.
© Copyright 2025 Coding Ahead. All rights reserved.
The vagus nerve blocking therapy (VBLOC) is indicated for patients suffering from morbid obesity. This condition is characterized by an excessive amount of body fat that presents significant health risks, including but not limited to diabetes, hypertension, and cardiovascular diseases. The therapy is specifically designed for individuals who have not achieved sustainable weight loss through traditional methods such as diet and exercise, and who may benefit from a surgical intervention to assist in weight management.
The procedure for vagus nerve blocking therapy involves several critical steps to ensure the effective removal of the pulse generator and the management of the implanted device. Initially, the device is programmed off to prepare for the surgical intervention. A small portal incision is made in the upper abdomen, through which a trocar is inserted to facilitate access. Following this, a pneumoperitoneum is established by insufflating carbon dioxide into the abdominal cavity, allowing for better visualization and access to the surgical area. Subsequently, two to three additional small incisions are made to introduce the necessary surgical instruments for the procedure.
Another small incision is created just above the umbilicus, through which a laparoscope is introduced. The liver is then retracted to expose the previously implanted electrode arrays located at the anterior and posterior esophagogastric junction. If the procedure requires the relocation of the existing electrode arrays, the surgeon will locate and reposition one or both arrays around the vagus nerve trunks as necessary. In cases where replacement of the electrode arrays is needed, a skin incision is made over the neuroregulator, allowing for the disconnection and removal of the old lead(s). New lead(s) are then placed as required.
If the neuroregulator itself also needs to be replaced, it is removed, and a new device is implanted in its place. The repositioned or newly placed leads are connected to the neuroregulator and tested to ensure proper functionality. If new leads have been installed, they are tunneled to the neuroregulator, connected, and tested again to confirm their operation. Finally, the neuroregulator is returned to its subcutaneous pocket, which is then closed with sutures. The neuroregulator is activated and programmed using a transmit coil and an external mobile charging unit to complete the procedure.
After the completion of the vagus nerve blocking therapy procedure, patients are typically monitored for any immediate complications related to the surgery. Post-procedure care may include pain management, wound care instructions, and guidelines for activity restrictions to promote healing. Patients are advised to follow up with their healthcare provider to assess the effectiveness of the therapy and to make any necessary adjustments to the neuroregulator settings. Recovery time may vary, but patients are generally encouraged to gradually resume normal activities as tolerated, while adhering to any specific recommendations provided by their surgical team.
| Short Descr | RMVL VAGUS NERVE PLS GEN | Medium Descr | REMOVAL PULSE GENERATOR VAGUS NERVE | Long Descr | Vagus nerve blocking therapy (morbid obesity); removal of pulse generator | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 244 - Gastric bypass and volume reduction |
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| 2022-12-31 | Deleted | Code deleted. For laparoscopic implantation, revision, replacement, or removal of vagus nerve blocking neurostimulator electrode array and/or pulse generator at the esophagogastric junction, use 64999. |
| 2013-01-01 | Added | First appearance in codebook. |
| 2012-01-01 | Added | Added |