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The CPT® Code 0818T refers to the procedure involving the revision or removal of an integrated neurostimulation system specifically designed for bladder dysfunction. This procedure encompasses several critical components, including the analysis, programming, and imaging of the neurostimulator when performed. The integrated neurostimulator is typically placed on the posterior tibial nerve, which is a branch of the sciatic nerve. This placement is intended to treat conditions such as overactive bladder or intractable urge incontinence by delivering retrograde neuromodulation to the sacral nerve plexus, which plays a vital role in controlling bladder function and lower urinary tract activity. During the procedure, the physician prepares the patient by marking the incision site and making an incision over the previous surgical site. The subcutaneous pocket is then opened to access the neurostimulator device. The device may be tested for its functionality and proper positioning, allowing for adjustments or complete removal if necessary. This procedure is particularly relevant when the neurostimulator has ceased to provide effective treatment, necessitating either its removal or revision to restore its efficacy. The final steps involve closing the fascia or irrigating the subcutaneous pocket and suturing the skin in layers to ensure proper healing.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 0818T is indicated for patients experiencing bladder dysfunction, specifically those suffering from conditions such as:
The procedure begins with the patient being prepped and draped to maintain a sterile environment. The physician then marks the incision site, which is typically located over the previous surgical incision. Following this, the skin is incised to access the subcutaneous pocket where the integrated neurostimulator device is located. In the case of CPT® Code 0818T, the subcutaneous pocket is opened to expose the device directly. Once the device is accessible, the physician may conduct tests to ensure proper positioning and functionality. This involves analyzing the device at various programmed pulse, frequency, and amplitude settings to determine if effective stimulation can still be achieved. If the device is found to be ineffective, the physician may proceed to either remove the device completely or revise it in situ. The revision may include adjusting the position of the device and placing new stay sutures to secure it. After the necessary adjustments or removal are completed, the fascia is closed, or the subcutaneous pocket is irrigated to prevent infection. Finally, the skin is closed in layers to promote optimal healing.
Post-procedure care for patients undergoing the revision or removal of an integrated neurostimulation system includes monitoring for any signs of infection or complications at the incision site. Patients may be advised on activity restrictions to allow for proper healing. Follow-up appointments are typically scheduled to assess the effectiveness of the procedure and to make any necessary adjustments to the neurostimulator if it has been revised. Patients should also be educated on signs of potential complications, such as increased pain, swelling, or unusual discharge from the incision site, and instructed to contact their healthcare provider if these occur.
| Short Descr | REVJ/RMVL INS PTN SUBQ | Medium Descr | REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBCUTANEOUS | Long Descr | Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
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| 2024-01-01 | Added | Code Added. |
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