© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 61886 involves the insertion or replacement of a cranial neurostimulator pulse generator or receiver. This device is crucial for delivering electrical impulses to specific areas of the brain, which can help manage various neurological conditions. The process begins with making an incision in the anterior chest, just below the clavicle, allowing access to the subcutaneous tissue where a pocket is created to house the pulse generator or receiver. In cases where a replacement is necessary, the existing device is accessed through an incision made directly over it, enabling the surgeon to disconnect the electrodes and remove the old device. The new pulse generator or receiver is then placed into either the existing pocket or a newly created one, ensuring it is properly connected to two or more electrode arrays. After the device is positioned, it is programmed to function according to the patient's needs, and the incision is meticulously closed in layers, often using sutures or staples. This procedure is distinct from similar codes, such as 61885, which pertains to the connection of a single electrode array, and 61888, which involves revisions or removals of the device. The careful execution of this procedure is essential for effective treatment and management of neurological disorders.
© Copyright 2025 Coding Ahead. All rights reserved.
The insertion or replacement of a cranial neurostimulator pulse generator or receiver, as described by CPT® Code 61886, is indicated for patients who require neuromodulation therapy for various neurological conditions. These may include, but are not limited to, chronic pain management, treatment of epilepsy, or other conditions that benefit from electrical stimulation of the brain. The procedure is performed when existing devices need replacement due to malfunction, battery depletion, or when a patient requires an upgrade to a more advanced neurostimulator system.
The procedure for the insertion or replacement of a cranial neurostimulator pulse generator or receiver involves several critical steps. First, the surgeon makes an incision in the anterior chest, just below the clavicle, which is then carried down to the subcutaneous tissue. This incision allows for the creation of a small pocket where the pulse generator or receiver will be placed. In cases where a replacement is necessary, the surgeon makes an incision directly over the existing device, allowing access to the subcutaneous pocket. The existing device is then carefully exposed, and the electrode(s) are disconnected. The surgeon dissects the device free from the surrounding tissue and removes it from the body. Following this, the new neurostimulator pulse generator or receiver is placed into the existing or newly fashioned subcutaneous pocket. The cranial electrode wire(s) are then connected to the new device. Once the connections are made, the pulse generator or receiver is programmed to ensure it functions correctly for the patient's needs. Finally, the incision is closed in layers using sutures, and the skin may be closed with staples to secure the area.
After the procedure, patients are typically monitored for any immediate complications related to the surgery. Post-procedure care may include pain management, wound care instructions, and follow-up appointments to ensure proper healing and device functionality. Patients may be advised to avoid strenuous activities for a specified period to allow for optimal recovery. Additionally, programming adjustments may be made during follow-up visits to ensure the neurostimulator is effectively managing the patient's symptoms. It is essential for patients to report any unusual symptoms or concerns to their healthcare provider promptly.
| Short Descr | IMPLANT NEUROSTIM ARRAYS | Medium Descr | INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS | Long Descr | Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 0 - 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 174 - Other non-OR therapeutic procedures on skin and breast |
| 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | GC | This service has been performed in part by a resident under the direction of a teaching physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2011-11-30 | Changed | Corrected spelling of vagus per Corrections Notice 2012. |
| 2011-01-01 | Changed | Guideline information changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2005-01-01 | Changed | Code description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
Get instant expert-level medical coding assistance.