How To Use CPT Code 64570

CPT 64570 describes the removal of a cranial nerve neurostimulator electrode array and 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 64570?

CPT 64570 can be used to describe the removal of a vagus nerve neurostimulator electrode array and pulse generator. This code is used when the provider removes both the electrode array and the pulse generator without replacing them. The removal may be necessary due to infection or if the patient is unresponsive or intolerant to treatment.

2. Official Description

The official description of CPT code 64570 is: ‘Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator.’

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made through the scar from the previous operation over the vagus neurostimulator.
3. The provider disconnects the lead from the generator and incises the scar over the electrode array.
4. Using microsurgical techniques, the provider exposes and gently dissects the electrodes from the nerve.
5. Excess scar tissue along the nerve may be trimmed if necessary.
6. The provider removes the existing generator pack.
7. The wounds and skin are closed with sutures or tissue adhesive.

4. Qualifying circumstances

Patients eligible to receive CPT 64570 services are those who have a vagus nerve neurostimulator electrode array and pulse generator that need to be removed. The removal may be necessary due to infection or if the patient is unresponsive or intolerant to treatment.

5. When to use CPT code 64570

CPT code 64570 should be used when the provider removes both the vagus nerve neurostimulator electrode array and pulse generator without replacing them. This code should not be reported in conjunction with CPT code 61888.

6. Documentation requirements

To support a claim for CPT 64570, the provider must document the following information:

• Reason for removal (infection, unresponsiveness, intolerance to treatment)
• Location of the electrode array and pulse generator
• Details of the procedure, including incisions, dissection, and removal
• Closure method used

7. Billing guidelines

When billing for CPT 64570, ensure that the provider is removing both the vagus nerve neurostimulator electrode array and pulse generator without replacing them. Do not report CPT 64570 in conjunction with CPT code 61888. Consider using codes 61885 and 61886 for replacement of a single or bilateral electrode array.

8. Historical information

CPT 64570 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 with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to infection.
2. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to unresponsiveness to treatment.
3. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to intolerance to treatment.
4. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to a combination of infection and unresponsiveness to treatment.
5. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to a combination of infection and intolerance to treatment.
6. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to a combination of unresponsiveness to treatment and intolerance to treatment.
7. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to a combination of infection, unresponsiveness to treatment, and intolerance to treatment.
8. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to a combination of infection and unresponsiveness to treatment, despite attempts to manage the condition.
9. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to a combination of infection and intolerance to treatment, despite attempts to manage the condition.
10. A patient with a vagus nerve neurostimulator electrode array and pulse generator undergoes removal of both without replacement due to a combination of unresponsiveness to treatment and intolerance to treatment, despite attempts to manage the condition.