CPT® Code 0720T

Official Description

Percutaneous electrical nerve field stimulation, cranial nerves, without implantation

Common Language Description

Percutaneous electrical nerve field stimulation (PENFS), also referred to as auricular neurostimulation, is a non-invasive therapeutic procedure designed specifically for pediatric patients aged 11 to 18 who are suffering from non-resolving abdominal pain related to irritable bowel syndrome (IBS). This innovative treatment approach was developed based on research indicating that certain IBS patients exhibit abnormal activity in the amygdala, a critical region of the brain responsible for regulating the autonomic nervous system, which plays a significant role in pain perception and response. During the PENFS procedure, electrodes are strategically placed in and around the external ear to deliver targeted electrical stimulation to the cranial nerve bundles. This stimulation aims to modify the transmission of pain signals, thereby reducing the sensitivity to abdominal pain experienced by the patient. A small, battery-operated electrical generator is positioned behind the ear to facilitate this stimulation. The treatment regimen typically involves administering PENFS for a total of 120 hours per week over a maximum duration of three consecutive weeks. While PENFS is generally considered safe, patients may experience mild side effects such as ear discomfort or an allergic reaction to the adhesive used for electrode placement. It is important to note that PENFS is contraindicated in individuals with certain medical conditions, including those who have cardiac pacemakers, hemophilia, or psoriasis. Additionally, this treatment may be utilized in conjunction with other therapeutic interventions to enhance overall patient care.

1. Indications

The procedure of percutaneous electrical nerve field stimulation (PENFS) is indicated for pediatric patients experiencing specific symptoms and conditions related to abdominal pain. The following are the explicitly provided indications for this procedure:

Non-resolving abdominal pain associated with irritable bowel syndrome (IBS).

2. Procedure

The PENFS procedure involves several key steps to ensure effective treatment. The following outlines the procedural steps as described:

Electrode Placement - The first step in the PENFS procedure is the careful placement of electrodes in and around the external ear. This positioning is crucial as it targets the cranial nerve bundles that are involved in pain perception. The electrodes must be placed accurately to ensure optimal stimulation of the nerve pathways.
Electrical Stimulation - Once the electrodes are in place, a small, battery-powered electrical generator is positioned behind the ear. This generator delivers controlled electrical stimulation to the cranial nerves. The stimulation is designed to alter the pain signals transmitted to the brain, thereby reducing the sensitivity to abdominal pain.
Treatment Duration - The treatment is administered over a specified period, typically involving a total of 120 hours per week for up to three consecutive weeks. This duration is essential to achieve the desired therapeutic effects and to allow the body to respond to the stimulation adequately.

3. Post-Procedure

After the completion of the PENFS procedure, patients may experience mild side effects, such as ear discomfort or potential adhesive allergies due to the materials used for electrode placement. It is important for healthcare providers to monitor the patient for any adverse reactions following the treatment. Recovery is generally straightforward, and patients can typically resume their normal activities shortly after the procedure. Additionally, PENFS may be combined with other therapeutic modalities to enhance treatment outcomes, depending on the individual needs of the patient. Continuous assessment of the patient's response to the therapy is recommended to determine the effectiveness of the treatment and to make any necessary adjustments in the management plan.

Short Descr	PRQ ELC NRV STIM CN WO IMPLT
Medium Descr	PERQ ELEC NRV FIELD STIMJ CRANIAL NRVS WO IMPLTJ
Long Descr	Percutaneous electrical nerve field stimulation, cranial nerves, without implantation
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)	1 - Statutory 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	Procedure or Service, Not Discounted when Multiple
Berenson-Eggers TOS (BETOS)	none
MUE	1