How To Use CPT Code 63688

CPT 63688 describes the revision or removal of an implanted spinal neurostimulator pulse generator or receiver. 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 63688?

CPT 63688 can be used to describe the revision or removal of an implanted spinal neurostimulator pulse generator or receiver. This code is used when a previously implanted device needs to be revised due to a failed battery or component malfunction, or when the stimulation is ineffective for the patient.

2. Official Description

The official description of CPT code 63688 is: ‘Revision or removal of implanted spinal neurostimulator pulse generator or receiver.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made over the vertebrae at the original surgical location.
3. The previously implanted neurostimulator pulse generator or receiver is exposed.
4. The provider carefully dissects the old unit from the subcutaneous pocket.
5. Any malfunction is checked and corrected, and the same generator may be repositioned if necessary.
6. If the neurostimulator pulse generator unit is to be removed, the provider carefully disconnects the lead terminals from the old generator and removes it.
7. The empty subcutaneous pocket is irrigated with an antibiotic solution and checked for hemostasis.
8. The incision is closed in layers and covered with sterile dressings.

4. Qualifying circumstances

Patients who may require CPT 63688 are those with a previously implanted spinal neurostimulator pulse generator or receiver that needs revision or removal. This procedure is performed when the device has a failed battery or component malfunction, or when the stimulation is ineffective for the patient.

5. When to use CPT code 63688

CPT code 63688 should be used when a provider performs the revision or removal of an implanted spinal neurostimulator pulse generator or receiver. It should not be used for the initial insertion or replacement of the device.

6. Documentation requirements

To support a claim for CPT 63688, the provider must document the following information:

• Reason for the revision or removal of the neurostimulator pulse generator or receiver
• Details of the procedure, including the incision location and size
• Any malfunction or repositioning of the generator
• Confirmation of successful removal or revision
• Use of anesthesia
• Postoperative care instructions

7. Billing guidelines

When billing for CPT 63688, ensure that the procedure involves the revision or removal of an implanted spinal neurostimulator pulse generator or receiver. Modifier 78 may be appended if the revision or removal occurs during the postoperative period of the initial procedure. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 63688 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with a previously implanted spinal neurostimulator pulse generator requires revision due to a failed battery.
2. A provider removes an ineffective spinal neurostimulator pulse generator from a patient and replaces it with a new one.
3. A patient experiences a component malfunction in their spinal neurostimulator pulse generator, and the provider performs a revision to correct the issue.
4. A previously implanted spinal neurostimulator pulse generator needs to be removed as it is no longer providing effective stimulation for the patient.
5. A patient requests the removal of their spinal neurostimulator pulse generator due to personal reasons, and the provider performs the procedure.
6. A provider revises the position of a spinal neurostimulator pulse generator to improve its effectiveness for the patient.
7. A patient’s spinal neurostimulator pulse generator requires revision due to a malfunctioning lead terminal.
8. A provider removes a spinal neurostimulator pulse generator that is causing discomfort and replaces it with a new one.
9. A previously implanted spinal neurostimulator pulse generator needs to be removed as the patient no longer requires its use.
10. A provider revises the programming of a spinal neurostimulator pulse generator to optimize its stimulation for the patient.