© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 64569 involves the revision or replacement of a cranial nerve neurostimulator electrode array, which may include the vagus nerve, a common target for neurostimulation aimed at controlling conditions such as epilepsy. A neurostimulator electrode array is a device that delivers electrical impulses to specific nerves, helping to modulate nerve activity and alleviate symptoms associated with various neurological disorders. In this procedure, the surgeon makes an incision in the skin and carefully dissects the surrounding soft tissues to access the existing electrode array and/or pulse generator. If any components are found to be defective, they are either repaired or replaced with new ones. The new or repaired electrode array is then positioned adjacent to the targeted cranial nerve, such as the vagus nerve, and connected to the existing pulse generator. Following the connection, stimulation is applied to evaluate motor responses, and adjustments are made to ensure optimal placement and functionality of the electrode array. Once satisfactory responses are achieved, the electrode array is secured in place, and if a new array is used, the wires are tunneled to connect to the pulse generator. The procedure concludes with the closure of the incision in layers, ensuring proper healing and protection of the underlying structures.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 64569 is indicated for patients requiring revision or replacement of a cranial nerve neurostimulator electrode array. This may be necessary due to various reasons, including:
The procedure for CPT® Code 64569 involves several detailed steps to ensure the successful revision or replacement of the neurostimulator electrode array:
After the completion of the procedure, patients may require monitoring for any immediate complications related to the surgery. Expected recovery includes managing any discomfort at the incision site and following up with the healthcare provider to assess the effectiveness of the neurostimulator. Patients may also need to undergo adjustments to the stimulation settings in subsequent visits to optimize therapeutic outcomes. Proper care of the incision site is essential to prevent infection and ensure healing. Patients should be advised on activity restrictions and signs of complications that warrant immediate medical attention.
| Short Descr | REVISE/REPL VAGUS N ELTRD | Medium Descr | REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV | Long Descr | Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 1 - Team surgeons could be paid, though... | 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 |
| 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). | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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.) | 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). | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | 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) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2018-01-01 | Changed | AMA guidelines changed |
| 2011-01-01 | Added | Added |
Get instant expert-level medical coding assistance.