How To Use CPT Code 64569

CPT 64569 describes the revision or replacement of a cranial nerve neurostimulator electrode array, including connection to an existing pulse generator. 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 64569?

CPT 64569 can be used to describe the revision or replacement of a cranial nerve neurostimulator electrode array, along with the connection to an existing pulse generator. This code is used when a healthcare provider needs to address issues such as malfunction or infection related to the implanted device.

2. Official Description

The official description of CPT code 64569 is: ‘Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator.’

3. Procedure

1. The healthcare provider locates the electrode array around the left vagus nerve within the carotid sheath.
2. The provider makes an incision through the scar from the original operation and disconnects the lead from the generator.
3. The provider carefully traces the lead to the anchored electrode array and exposes the electrodes using microsurgical techniques.
4. If necessary, the provider may adjust the electrodes or replace the electrode array by placing new electrodes at a new position on the nerve.
5. The provider then attaches a new array, tunnels the new lead subcutaneously to the subclavicular pocket, attaches the lead to the existing generator pack, and tests the unit.
6. Once tests are successful, the provider secures the pack into the pocket and closes the wounds and skin with sutures or tissue adhesive.

4. Qualifying circumstances

CPT 64569 is performed when there is a need to revise or replace a cranial nerve neurostimulator electrode array, including connection to an existing pulse generator. This procedure is typically done to address issues such as malfunction or infection related to the implanted device.

5. When to use CPT code 64569

CPT code 64569 should be used when a healthcare provider performs the revision or replacement of a cranial nerve neurostimulator electrode array, including connection to an existing pulse generator. It is important to note that this code should not be reported in conjunction with codes 64570 or 61888, which identify the removal of the electrode array and the pulse generator of the stimulator.

6. Documentation requirements

To support a claim for CPT 64569, the healthcare provider must document the following information:

• Reason for the revision or replacement of the electrode array
• Details of the procedure, including the location of the electrode array and the steps taken to revise or replace it
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 64569, ensure that the procedure involves the revision or replacement of a cranial nerve neurostimulator electrode array, including connection to an existing pulse generator. It is important to note that codes 64568 and 64569 cannot be reported with code 64570. Additionally, for the replacement of the pulse generator, code 61885 should be used.

8. Historical information

CPT 64569 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Examples

1. A patient develops an infection related to the cranial nerve neurostimulator electrode array, and the healthcare provider performs a revision of the array, including connection to the existing pulse generator.
2. A patient experiences malfunction of the cranial nerve neurostimulator electrode array, and the healthcare provider replaces the array, including connection to the existing pulse generator.
3. A patient requires adjustment of the cranial nerve neurostimulator electrode array due to changes in their condition, and the healthcare provider revises the array, including connection to the existing pulse generator.
4. A patient undergoes a revision of the cranial nerve neurostimulator electrode array and replacement of the pulse generator due to both malfunction and infection.
5. A patient needs a replacement of the cranial nerve neurostimulator electrode array and connection to the existing pulse generator due to electrode migration.
6. A patient experiences a fracture of the cranial nerve neurostimulator electrode array, and the healthcare provider performs a revision, including connection to the existing pulse generator.
7. A patient requires a replacement of the cranial nerve neurostimulator electrode array and connection to the existing pulse generator due to electrode breakage.
8. A patient develops an infection related to the cranial nerve neurostimulator electrode array, and the healthcare provider performs a revision of the array, including connection to the existing pulse generator.
9. A patient experiences malfunction of the cranial nerve neurostimulator electrode array, and the healthcare provider replaces the array, including connection to the existing pulse generator.
10. A patient requires adjustment of the cranial nerve neurostimulator electrode array due to changes in their condition, and the healthcare provider revises the array, including connection to the existing pulse generator.