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The procedure described by CPT® Code 64584 involves the surgical removal of a hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array. A hypoglossal nerve stimulator is a medical device implanted to treat moderate to severe obstructive sleep apnea (OSA), a condition characterized by repeated episodes of airway obstruction during sleep, often caused by the relaxation of the tongue which can block the throat. The device functions by detecting the patient's breathing patterns and delivering electrical impulses to the hypoglossal nerve, which in turn stimulates the tongue to move forward, thereby keeping the airway open and facilitating normal breathing during sleep. The components of the device include a pulse generator, which is a small device similar in size to a quarter, a breathing sensor that detects inhalation, and a stimulation electrode that is placed around the hypoglossal nerve. These components are interconnected by tunneled electrical leads, allowing for a remote-controlled and programmable operation. The patient activates the device before sleep to ensure the stimulation occurs as needed. In cases where the device malfunctions or becomes infected, surgical intervention may be required to revise or replace the components. If a complete removal of the device is necessary, the procedure is performed through the original incision sites to safely extract the pulse generator, chest sensor, and hypoglossal stimulator electrode.
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The procedure associated with CPT® Code 64584 is indicated for patients who have a hypoglossal nerve neurostimulator that requires removal due to various reasons, including:
The removal of the hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode involves several key procedural steps:
After the removal of the hypoglossal nerve neurostimulator components, patients may require monitoring for any immediate post-operative complications, such as bleeding or infection at the incision sites. Recovery typically involves follow-up appointments to assess healing and ensure that the surgical sites are free from infection. Patients may also receive instructions on wound care and activity restrictions to promote optimal recovery. The overall recovery time can vary based on individual health factors and the extent of the procedure performed.
| Short Descr | RMVL HPGLSL NSTIM ARY PG | Medium Descr | REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR | Long Descr | Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array | 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 | T-Packaged Codes | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | 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. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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.) | 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). | 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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| 2022-01-01 | Added | Code added |
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