Outpatient Facility Coding Alert

You Be the Coder:

Consider Cat III Add-Ons With Placement of Hypoglossal Nerve Stimulator

Published on Fri Dec 14, 2018

PDF

Question: What’s the CPT^® code for the placement of a hypoglossal nerve stimulator? I can’t seem to find a code that includes both the placement of the stimulator and the chest wall respiratory sensor electrode.

Indiana Subscriber

Answer: Prior to 2017, you’d have had to report code 64999 (Unlisted procedure, nervous system) when the provider performed the placement of both the stimulator and chest wall respiratory sensor electrode. If the provider only performs the placement of the hypoglossal nerve stimulator, you will simply report code 64568 (Incision for implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator).

In 2017, CPT^® introduced the following three Category III codes that you will use to report the physician’s placement of the chest wall respiratory sensor electrode:

+0466T — Insertion of chest wall respiratory sensor electrode or electrode array, including connection to pulse generator (List separately in addition to code for primary procedure)
0467T — Revision or replacement of chest wall respiratory sensor electrode or electrode array, including connection to existing pulse generator
0468T — Removal of chest wall respiratory sensor electrode or electrode array.

For the service you’ve described, you should report 64568 and +0466T. For follow-up services involving the revision and/or replacement of the hypoglossal nerve stimulator and chest wall respiratory sensor electrode, you should report one of the above category III codes along with the following respective revision and removal of hypoglossal nerve stimulator codes:

64569 — Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator
64570 — Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator.