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The procedure described by CPT® Code 64553 involves the percutaneous implantation of a neurostimulator electrode array targeting a cranial nerve, with a common application being the vagus nerve for the management of epileptic seizures. This minimally invasive technique is designed to deliver electrical stimulation to specific cranial nerves, which can modulate neural activity and potentially alleviate symptoms associated with various neurological conditions. The vagus nerve, in particular, plays a significant role in autonomic functions and has been identified as a therapeutic target for seizure control. During the procedure, careful anatomical preparation and precise placement of the electrode array are critical to ensure effective stimulation. The use of ultrasound guidance may be employed to enhance the accuracy of electrode placement, thereby optimizing the therapeutic outcomes for patients. The overall goal of this procedure is to establish a reliable interface between the neurostimulator and the targeted nerve, facilitating ongoing stimulation that can lead to improved clinical results.
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The percutaneous implantation of a neurostimulator electrode array, as described by CPT® Code 64553, is indicated for the following conditions:
The procedure for the percutaneous implantation of a neurostimulator electrode array involves several critical steps to ensure proper placement and functionality of the device.
Post-procedure care involves monitoring the patient for any immediate complications and ensuring that the electrode array is functioning correctly. Patients may be advised on activity restrictions and follow-up appointments to assess the effectiveness of the neurostimulation. It is important to evaluate the patient's response to the stimulation over time and make any necessary adjustments to the external generator/receiver settings to optimize therapeutic outcomes.
| Short Descr | IMPLANT NEUROELECTRODES | Medium Descr | PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE | Long Descr | Percutaneous implantation of neurostimulator electrode array; cranial nerve | Status Code | Active Code | Global Days | 010 - Minor Procedure | 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) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| 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. | 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. | 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.) | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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Notes
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| 2018-01-01 | Changed | AMA guideline added. |
| 2012-01-01 | Changed | Description Changed |
| 2011-11-30 | Changed | Corrected spelling of vagus, per Corrections Notice 2012 |
| Pre-1990 | Added | Code added. |
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