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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 reduce the sensation of hunger, thereby assisting patients in managing their weight. The procedure involves the replacement of the pulse generator, which is a key component of the VBLOC system, ensuring that the therapy continues to function effectively. The process requires careful surgical intervention, including the establishment of a pneumoperitoneum and the use of laparoscopic techniques to access the necessary anatomical structures while minimizing patient recovery time and surgical complications.
© 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 aims to assist in weight management by altering the signals of hunger and satiety transmitted by the vagus nerve.
The procedure for replacing the pulse generator in vagus nerve blocking therapy involves several critical steps to ensure successful implantation and functionality of the device. Initially, the device is programmed off to prevent any unintended stimulation during the surgical process. A small portal incision is made in the upper abdomen, through which a trocar is inserted to facilitate access to the abdominal cavity. Following this, a pneumoperitoneum is established by insufflating carbon dioxide, creating a working space for the surgeon. Subsequently, two to three additional small incisions are made to allow the introduction of necessary surgical instruments. A laparoscope is then introduced through a small incision located just above the umbilicus, providing visual access to the surgical site. The liver is carefully 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 needed. In cases where replacement of the electrode arrays is necessary, 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, and if the neuroregulator also requires replacement, it is removed and a new device is implanted. The repositioned or newly placed leads are connected to the neuroregulator and tested to ensure proper functionality. If new leads have been placed, they are tunneled to the neuroregulator, connected, and tested again. 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 procedure, patients are typically monitored for any immediate complications related to the surgery. Post-operative care may include pain management and instructions on activity restrictions to promote healing. Patients are advised to follow up with their healthcare provider to ensure the proper functioning of the neuroregulator and to make any necessary adjustments to the therapy settings. Recovery time may vary, but patients can generally expect to resume normal activities within a few weeks, depending on individual healing processes and any additional health considerations.
| Short Descr | REPLC VAGUS NERVE PLS GEN | Medium Descr | REPLACEMENT PULSE GENERATOR VAGUS NERVE | Long Descr | Vagus nerve blocking therapy (morbid obesity); replacement 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. |
| 2013-01-01 | Changed | Guideline information changed. |
| 2012-01-01 | Added | Added |
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