CPT® Code 0787T

1. Indications

The procedure associated with CPT® Code 0787T is indicated for specific clinical scenarios related to sacral nerve stimulation. These indications include:

• Migration of Electrode Array The existing sacral neurostimulator electrode array may have shifted from its original placement, necessitating revision to restore optimal function.
• Infection In cases where there is an infection present at the site of the electrode array, removal of the device may be required without replacement to prevent further complications.

2. Procedure

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

• Step 1: Incision The surgeon begins by making incisions at the sacral foramen level, which corresponds to the previous placement site of the electrode array. This access point is crucial for reaching the underlying structures.
• Step 2: Dissection Following the incision, careful dissection is performed to expose the sensor lead(s) that have been placed through the foramen. This step requires precision to avoid damaging surrounding tissues.
• Step 3: Electrode Lead Management Once the sensor lead(s) are accessible, they are meticulously dissected free from the sacral nerve. Depending on the clinical need, the lead(s) may be repositioned to ensure proper function or removed entirely.
• Step 4: Testing and Securing If the lead(s) are repositioned, they are tested for appropriate positioning responses to confirm their effectiveness. After testing, the lead(s) are secured again with the implantable pulse generator (IPG) in its subcutaneous pocket.
• Step 5: Closure If the decision is made to remove the lead(s), they are extracted completely from their subcutaneous tunnel along with the existing IPG device. The surgical site is then closed appropriately to promote healing.

3. Post-Procedure

After the procedure, patients may require specific post-operative care to ensure proper recovery. This may include monitoring for signs of infection at the incision site, managing pain, and following up with the healthcare provider to assess the effectiveness of the procedure. Patients should be advised on activity restrictions and any signs or symptoms that would warrant immediate medical attention. The overall recovery process will depend on the extent of the procedure performed, whether it involved revision or complete removal of the device.