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The procedure described by CPT® Code 61889 involves the insertion of a skull-mounted cranial neurostimulator pulse generator or receiver, which is a specialized device used primarily for the treatment of epilepsy that does not respond to conventional medication. This procedure is particularly relevant for patients suffering from refractory epilepsy and other neurological disorders. The neurostimulator is designed to be implanted beneath the scalp and within the skull, necessitating a surgical intervention that may include a craniectomy or craniotomy, depending on the specific requirements of the case. During the procedure, the neurostimulator is connected to electrodes that are strategically placed either within the brain tissue or on the surface of the brain. The primary function of this device is to continuously monitor the brain's electrical activity, allowing it to detect the onset of seizures. Once a seizure is detected, the neurostimulator can emit a small electrical signal intended to interrupt or shorten the seizure episode, potentially preventing it altogether. This responsive neurostimulation approach has been shown to reduce the frequency of seizures over time and enhance the overall quality of life for patients. However, it is important to note that the benefits of the device may take several months to manifest, and initial results may not be immediately apparent. Patient engagement plays a crucial role in the effectiveness of this treatment, as it involves regular monitoring and data management, including the daily downloading of information from the neurostimulator to a computer and the use of a magnet to log seizure occurrences. While the procedure can offer significant benefits, there are risks involved, including potential complications such as infection at the implant site, intracranial hemorrhage, or neurological impairment. Additionally, there is a possibility that the procedure may not achieve the desired outcome of reducing or halting seizures in some patients.
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The insertion of a skull-mounted cranial neurostimulator pulse generator is indicated for patients with specific neurological conditions, particularly those who experience:
The procedure for the insertion of the cranial neurostimulator pulse generator involves several critical steps:
Following the procedure, patients typically require monitoring in a recovery area to ensure stability as the anesthesia wears off. Post-operative care may include pain management and observation for any immediate complications. Patients are often advised on how to care for the surgical site to prevent infection. Over the following weeks and months, patients will need to engage in regular follow-up appointments to assess the functionality of the neurostimulator and to program it according to their specific seizure patterns. It is essential for patients to actively participate in their treatment by downloading data from the device and using a magnet to log seizure occurrences, as this information is vital for optimizing the device's performance and ensuring the best possible outcomes.
| Short Descr | INS SK-MNT CRNL NSTM PG/RCVR | Medium Descr | INSERTION SKULL-MNTD CRANIAL NSTIM PG/RECEIVER | Long Descr | Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s) | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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) |
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| 2024-01-01 | Added | Code Added. |
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