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The procedure described by CPT® Code 64596 involves the insertion or replacement of a percutaneous electrode array that is designed for peripheral nerve stimulation. This procedure is specifically aimed at patients suffering from intractable pain, which is pain that does not respond to conventional treatments. The device used in this procedure is a small, single-unit neurostimulator and electrode array, comparable in size to a standard staple. Its primary function is to disrupt the transmission of pain signals from the affected nerve to the brain by delivering mild electrical impulses once activated. The procedure begins with the identification of the target nerve, followed by the administration of local anesthesia to ensure patient comfort. An introducer needle is then utilized to position the integrated neurostimulator and electrode array adjacent to the nerve, with imaging guidance, typically ultrasound, to enhance accuracy. The external pulse transmitter, which is worn externally over the electrode, allows for wireless stimulation of the nerve through a handheld remote control that is programmed by a qualified healthcare professional. This setup enables the physician to adjust the stimulation settings to optimize pain relief for the patient. Additionally, if necessary, more electrode arrays can be inserted during the same session, as indicated by CPT® Code 64597, allowing for a comprehensive approach to managing the patient's pain.
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The procedure associated with CPT® Code 64596 is indicated for patients experiencing intractable pain that has not responded to other forms of treatment. This may include various types of chronic pain conditions where traditional pain management strategies have failed to provide adequate relief.
The procedure begins with the identification of the target peripheral nerve that is responsible for the patient's pain. Once the nerve is located, local anesthesia is administered to ensure that the patient remains comfortable throughout the procedure. Following this, an introducer needle is utilized to facilitate the placement of the integrated neurostimulator and electrode array. This step is performed percutaneously, meaning that it is done through the skin without the need for a large incision. Imaging guidance, typically ultrasound, is employed during this process to ensure precise placement of the electrode array adjacent to the nerve. This imaging technique enhances the accuracy of the procedure and minimizes the risk of complications.
Once the electrode array is positioned correctly, the external pulse transmitter is placed over the lead or electrode. This transmitter is worn externally and is responsible for delivering electrical impulses to the target nerve. The physician or qualified healthcare professional then uses a handheld wireless remote control to program the pulse transmitter, adjusting the stimulation settings to meet the specific needs of the patient. Active stimulation guidance may also be performed during the procedure to confirm that the electrode array is correctly positioned and effectively stimulating the nerve.
In cases where additional pain management is required, the physician may opt to place more electrode arrays during the same session, as indicated by CPT® Code 64597. This allows for a more comprehensive approach to addressing the patient's pain.
After the procedure, patients are typically monitored for any immediate complications or adverse reactions. Post-procedure care may include instructions on how to care for the insertion site, as well as guidelines on activity restrictions to ensure proper healing. Patients may also receive information on how to use the external pulse transmitter and remote control for optimal pain management. Follow-up appointments are usually scheduled to assess the effectiveness of the neurostimulator and to make any necessary adjustments to the stimulation settings.
| Short Descr | INS/RPLCMT PRQ ELTRD RA PN 1 | Medium Descr | INSJ/RPLCMT PERQ ELTRD RA PN W/INT NSTIM 1ST RA | Long Descr | Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array | Status Code | Carriers Price the 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) | 1 - Statutory 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) | none | MUE | 1 |
This is a primary code that can be used with these additional add-on codes.
| 64597 | Add-on code MPFS Status: Carrier Priced APC N ASC N1 Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separately in addition to code for primary procedure) |
| 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. | 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) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2024-01-01 | Added | Code Added. |
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