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The procedure described by CPT® Code 61891 involves the revision or replacement of a skull-mounted cranial neurostimulator pulse generator or receiver. This device is typically utilized in the management of conditions such as drug-resistant focal epilepsy, where traditional treatments have proven ineffective. The cranial neurostimulator functions by delivering electrical impulses to specific areas of the brain, thereby modulating neural activity and potentially alleviating seizure episodes. In cases where the device malfunctions, experiences complications, or is subject to injury, a revision or replacement becomes necessary. The procedure is performed under general anesthesia to ensure the patient's comfort and safety. During the operation, a scalp flap is created to access the neurostimulator, allowing the surgeon to evaluate the device's condition. If required, the device may be repositioned or replaced entirely. Additionally, the connections to the depth and/or cortical strip electrode arrays implanted in the brain are assessed to ensure proper functionality. Any signs of infection in the area surrounding the implant are meticulously addressed to prevent further complications. Once the necessary adjustments or replacements are made, the neurostimulator pulse generator is securely anchored within the skull, and the scalp flap is sutured closed to promote healing.
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The procedure associated with CPT® Code 61891 is indicated for patients who require intervention on their cranial neurostimulator due to specific conditions or complications. These indications include:
The procedure for CPT® Code 61891 involves several critical steps to ensure the successful revision or replacement of the cranial neurostimulator pulse generator. These steps include:
Following the procedure associated with CPT® Code 61891, patients are typically monitored for any immediate complications related to anesthesia and the surgical site. Post-operative care may include pain management, wound care instructions, and follow-up appointments to assess healing and device functionality. Patients may also be advised on activity restrictions to promote recovery and minimize the risk of complications. It is essential for healthcare providers to monitor the patient for any signs of infection or device malfunction during the recovery period.
| Short Descr | REV/RPLCMT SK-MNT CRNL NSTM | Medium Descr | REVJ/RPLCMT SKULL-MNTD CRANIAL NSTIM PG/RECEIVER | Long Descr | Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver 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 | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 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. | 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). | 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.) | 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 | 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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