CPT® Code 0785T

1. Indications

The procedure described by CPT® Code 0785T is indicated for specific clinical situations related to spinal neurostimulator electrode arrays. These indications include:

• Migration of Electrode Array The procedure may be performed when the existing spinal neurostimulator electrode array has migrated from its original placement, potentially leading to ineffective pain management.
• Infection Removal of the neurostimulator electrode array is indicated in cases where there is an infection present, necessitating the extraction of the device to prevent further complications.

2. Procedure

The procedure for the revision or removal of a neurostimulator electrode array involves several critical steps, which are detailed as follows:

• Step 1: Incision An incision is made at the previous placement site of the spinal neurostimulator electrode array. This allows the surgeon to access the subcutaneous pocket where the device is located.
• Step 2: Accessing the Device The subcutaneous pocket containing the existing neurostimulator device is opened carefully. This step is crucial to avoid damaging surrounding tissues and to ensure a clear view of the device.
• Step 3: Device Management Depending on the clinical situation, the neurostimulator device may either be carefully removed from its pocket or repositioned within the pocket. If repositioning is necessary, the surgeon verifies the electrode placement to ensure proper impedance and effectiveness in pain relief.
• Step 4: Closure After the necessary adjustments are made, the wound is irrigated to reduce the risk of infection and then closed in layers. This layered closure technique helps to promote optimal healing and minimizes the risk of complications such as further migration of the device.

3. Post-Procedure

Post-procedure care following the revision or removal of a neurostimulator electrode array includes monitoring the surgical site for signs of infection, ensuring proper healing, and assessing the effectiveness of the device if it has been repositioned. Patients may be advised on activity restrictions to promote recovery and prevent complications. Follow-up appointments are typically scheduled to evaluate the patient's pain management and the functionality of the neurostimulator, if applicable.