CPT® Code 61860

1. Indications

The procedure is indicated for patients who may benefit from neurostimulation therapy for various neurological conditions. The following are explicitly provided indications for the procedure:

• Epilepsy Patients with refractory epilepsy who do not respond to conventional treatments may require neurostimulator electrodes to help control seizures.
• Chronic Pain Individuals suffering from chronic pain syndromes may be candidates for this procedure to alleviate pain through electrical stimulation of the brain.
• Movement Disorders Patients with movement disorders, such as Parkinson's disease, may also be considered for this intervention to improve motor function.

2. Procedure

The procedure involves several critical steps to ensure the successful implantation of neurostimulator electrodes. Each step is essential for achieving the desired therapeutic outcomes.

• Step 1: Anesthesia Administration The patient is first placed under general anesthesia to ensure they are completely unconscious and pain-free during the procedure. This is crucial for both the comfort of the patient and the safety of the surgical team.
• Step 2: Skull Access The surgeon makes an incision in the scalp and carefully removes a section of the skull, which may involve either a craniectomy or craniotomy. This step is vital as it provides direct access to the brain's surface where the electrodes will be implanted.
• Step 3: Electrode Placement Once access to the brain is achieved, the surgeon precisely places the neurostimulator electrodes onto the cortical surface. This requires meticulous attention to detail to ensure that the electrodes are positioned in the correct areas to maximize therapeutic effects.
• Step 4: Closure After the electrodes are securely implanted, the surgeon will close the incision in the skull, either by replacing the removed bone flap or using a synthetic material. The scalp incision is then sutured or stapled to promote healing.

3. Post-Procedure

Following the procedure, patients are typically monitored in a recovery area until the effects of anesthesia wear off. Post-operative care may include pain management, monitoring for any signs of infection, and ensuring that the patient is stable. Patients may also require follow-up appointments to assess the functionality of the implanted electrodes and to make any necessary adjustments to the neurostimulator settings. Recovery time can vary, but patients are generally advised to avoid strenuous activities for a specified period to allow for proper healing.