CPT Code 64570 | Description & Clinical Information

CPT 64570 describes the removal of both a vagus nerve electrode array and an existing pulse generator, which is only reported when both are removed without replacement due to reasons such as infection, unresponsiveness, or intolerance to treatment.

Official Description

The CPT book defines CPT code 64570 as: “Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator”.

Billing Guidelines

Do not code 64570 together with 61888. Instead, use CPT before each number when reporting.

Clinical Information

The procedure describes by CPT code 64570 is a neurostimulator electrode removal that involves the removal of the electrode array that is located around the left vagus nerve within the carotid sheath. It also includes taking out the lead and existing electronic pulse generator pack.

Before the procedure begins, the patient is appropriately prepped and anesthetized to ensure their comfort and safety. The provider then makes an incision through the scar from the previous operation over the vagus neurostimulator. Once the incision is made, she disconnects the lead from the generator.

The provider then incises the scar over the electrode array and carefully traces the lead to the anchored electrode. This process requires the use of loupe magnification or an operating microscope to ensure precision. Using microsurgical techniques, the electrodes are carefully exposed, and the provider dissects them from the nerve.

During the process, the provider may trim excess scar tissue along the nerve if necessary. The nerve is then sutured closed and returned back to its tissue bed. The existing generator pack is then carefully removed.

Once the procedure is complete, the provider closes the wounds and skin with sutures and/or tissue adhesive. The patient is then monitored and discharged after a post-operation evaluation.

Neurostimulator electrode removal is a complex procedure that requires expertise and precision. It’s vital to have a highly skilled provider who can perform the procedure with minimal harm to the patient. The use of microsurgical techniques, magnification, and careful dissection all contribute to a successful outcome.

The patient may experience some discomfort and swelling after the procedure; however, this typically subsides in a few days. Patients are advised to follow their provider’s post-operative instructions to ensure proper healing and to avoid complications.

In conclusion, the CPT code 64570 neurostimulator electrode removal is a critical procedure that involves the removal of an electrode array located around the left vagus nerve within the carotid sheath. This procedure is performed by a highly skilled provider who uses microsurgical techniques and magnification to ensure precision and minimal harm to the patient. Proper post-operative care is essential for optimal healing and to avoid complications.

Return to all the CPT codes for neurostimulator procedures on the peripheral nerves.

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