© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 0819T 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 neurostimulation system when performed. The focus of this procedure is on the posterior tibial nerve, which is a branch of the sciatic nerve. The neurostimulator device, which may have been previously placed subcutaneously or subfascially, is utilized to treat conditions such as overactive bladder or intractable urge incontinence. The mechanism of action involves stimulating the posterior tibial nerve to deliver 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 procedure may involve either the complete removal of the device or a revision in situ, which includes adjustments to the device's position and the placement of new stay sutures if necessary. This is particularly relevant in cases where the neurostimulator has ceased to provide effective treatment. The procedure concludes with the closure of the fascia or irrigation of the subcutaneous pocket, followed by layered closure of the skin.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 0819T 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, an incision is made in the skin to access the underlying tissues. In the case of a subcutaneous device, the subcutaneous pocket is opened to expose the neurostimulator device. For a subfascial device, the crural fascia is carefully divided to locate the device. Once the device is accessed, 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 assess whether effective stimulation can still be achieved. If the device is found to be ineffective, the physician may proceed with its complete removal or perform a revision in situ, which includes adjusting the device's position and placing new stay sutures to secure it. This step is crucial for restoring the efficacy of the neurostimulator. After the necessary adjustments or removal, the fascia is closed, or the subcutaneous pocket is irrigated to prevent infection, and the skin is then closed in layers to complete the procedure.
Post-procedure care involves monitoring the patient for any immediate complications and ensuring proper healing of the incision site. Patients may be advised on activity restrictions to promote healing and prevent strain on the surgical area. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to make any necessary adjustments to the neurostimulator settings if it remains in place. Additionally, patients should be educated on signs of infection or other complications that may require prompt medical attention.
| Short Descr | REVJ/RMVL INS PTN SUBF | Medium Descr | REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBFASCIAL | Long Descr | Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial | 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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