Neurosurgery Coding Alert

Question: When a neurosurgeon replaces an old VNS generator with a new generator, should I report 61885-61886 alone, or should I report 61885-61886 along with 61888?


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Answer: You should only report 61885 (Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array) or 61886 (... with connection to two or more electrode arrays). These codes are for insertion or replacement of a neurostimulator.

Tip: The difference between 61885 and 61886 is the number of electrode arrays your neurosurgeon connects to the generator. Use 61885 if the neurosurgeon places a neurostimulator pulse generator or receiver that's attached to a single electrode array. Use 61886 to report the generator placement when it is attached to multiple electrode arrays.

Bottom line: You should only bill one code for the removal and/or replacement when it is performed through the same incision. Since January 2005, CPT has specifically directed physicians that they should not report 61888 (Revision or removal of cranial neurostimulator pulse generator or receiver) in conjunction with 61885 or 61886 for the same pulse generator. Therefore, you should use 61885 when the generator is replaced through the same incision. When the neurosurgeon only performs a removal or revision, use 61888.