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The CPT® Code 64568 refers to the open implantation of a cranial nerve neurostimulator electrode array and pulse generator. This procedure is specifically designed for the placement of a neurostimulator that targets cranial nerves, with the vagus nerve being one of the most commonly stimulated nerves, particularly for the management of epileptic seizures. The procedure involves a surgical approach where the planned insertion site, typically located in the neck, is meticulously prepared. The process begins with an incision in the skin, followed by careful dissection of the soft tissues to reveal the vagus nerve and the surrounding carotid artery sheath. Once the vagus nerve is exposed, the electrode array is strategically positioned adjacent to it. This array is then connected to a power source, allowing for stimulation to be applied while monitoring motor responses to ensure proper placement and functionality. The electrode array may be adjusted and retested multiple times to achieve optimal responses before being secured in place. Additionally, a subcutaneous pocket is created to house the pulse generator, which is connected to the electrode array through tunneled wires. After thorough testing of the generator and leads, the surgical site is closed in layers, ensuring that the electrode array remains properly positioned and secured within the neck tissues.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 64568 is indicated for patients who require neuromodulation through the stimulation of cranial nerves, particularly in the context of managing specific medical conditions. The primary indications for this procedure include:
The open implantation procedure for the cranial nerve neurostimulator involves several critical steps to ensure successful placement and functionality of the device. The steps are as follows:
After the completion of the procedure, patients typically require monitoring for any immediate complications. Post-procedure care may include pain management, wound care instructions, and follow-up appointments to assess the functionality of the neurostimulator. Patients are advised on activity restrictions to promote healing and prevent dislodgment of the electrode array. Regular follow-up visits are essential to evaluate the effectiveness of the stimulation in managing seizures and to make any necessary adjustments to the device settings.
| Short Descr | OPN IMPLTJ CRNL NRV NEA&PG | Medium Descr | OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN | Long Descr | Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator | 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 | 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 |
| 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 | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 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). | 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.) | 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). | AG | Primary physician | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2022-01-01 | Changed | Code description changed. |
| 2018-01-01 | Note | AMA guidelines changed |
| 2011-01-01 | Added | Added |
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