How To Use CPT Code 63664

CPT 63664 describes the revision and replacement of spinal neurostimulator electrode plates or paddles that were previously placed through laminotomy or laminectomy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 63664?

CPT 63664 can be used to describe the revision and replacement of spinal neurostimulator electrode plates or paddles that were previously placed through laminotomy or laminectomy. This code is used when the provider revises the electrode plates or paddles to improve their function, such as by adjusting their placement, or when the provider replaces the electrode plates or paddles altogether.

2. Official Description

The official description of CPT code 63664 is: ‘Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed.’

3. Procedure

1. The provider identifies the site of the original incision over a vertebral segment and makes a new incision in the same area.
2. He then incises any adhesions and retracts the paravertebral muscles, fascia, and ligaments to gain access to the neurostimulator electrode plates or paddles.
3. The provider revises the electrode plates or paddles to allow for better function, such as by adjusting their placement.
4. He may also replace the electrode plates or paddles if necessary.
5. The provider closes the wound by suturing the skin layers together.
6. Fluoroscopy may be used to guide the procedure.

4. Qualifying circumstances

Patients eligible to receive CPT 63664 services are those who have previously undergone a laminotomy or laminectomy procedure and have spinal neurostimulator electrode plates or paddles in place. The revision or replacement of these electrode plates or paddles must be necessary to improve their function. The procedure must be performed by a qualified provider and may include the use of fluoroscopy.

5. When to use CPT code 63664

CPT code 63664 should be used when the provider performs a revision and/or replacement of spinal neurostimulator electrode plates or paddles that were previously placed through laminotomy or laminectomy. This code should be reported when the revision or replacement is performed, and should not be reported in conjunction with CPT codes 63661 or 63662 for the same spinal level.

6. Documentation requirements

To support a claim for CPT 63664, the provider must document the following information:

• Indication for the revision or replacement of the electrode plates or paddles
• Details of the procedure, including the site of the original incision, the new incision, and any adhesions encountered
• Description of the revision or replacement performed, including any adjustments made to the placement of the electrode plates or paddles
• Use of fluoroscopy, if applicable
• Closure of the wound and suturing of the skin layers

7. Billing guidelines

When billing for CPT 63664, ensure that the procedure meets the qualifying circumstances and is performed by a qualified provider. Do not report CPT 63664 in conjunction with CPT codes 63661 or 63662 for the same spinal level. Use modifier TC for facility reporting and modifier 26 for professional reporting, if applicable.

8. Historical information

CPT 63664 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A provider revising the placement of spinal neurostimulator electrode plates for a patient who previously underwent laminotomy.
2. A provider replacing spinal neurostimulator electrode paddles for a patient who previously underwent laminectomy.
3. A provider adjusting the placement of spinal neurostimulator electrode plates for a patient to improve their function.
4. A provider replacing spinal neurostimulator electrode plates for a patient due to malfunction.
5. A provider revising and replacing spinal neurostimulator electrode paddles for a patient to optimize their pain management.
6. A provider revising the placement of spinal neurostimulator electrode plates for a patient to address inadequate pain relief.
7. A provider replacing spinal neurostimulator electrode paddles for a patient due to infection.
8. A provider adjusting the placement of spinal neurostimulator electrode plates for a patient to improve coverage of pain relief.
9. A provider replacing spinal neurostimulator electrode plates for a patient due to electrode migration.
10. A provider revising and replacing spinal neurostimulator electrode paddles for a patient to address lead fracture.