Wiki Axonics nerve stimulator implant

[KaylaRieken]

Can I get help with what code to use? Is this 64561 or 64581?

Under fluoroscopic guidance, we did access the S3 foramen with a percutaneous needle bilaterally. Testing demonstrated adequate bellows and great toe plantar flexion which was better obtained in the left foramen. The inner stylet was removed from the percutaneous needle, and the directional guide was inserted. We then proceeded to make a small skin incision with a scalpel blade over the directional guide. The percutaneous needle was removed, and then we proceeded to place the dilator under fluroscopic guidance. The inner stylet of the dilator was removed. And the permanent lead was obtained.

Is this considered "open" because they made a small incision?

 

[csperoni]

I am new to neurostim implants, and my physicians only place them percutaneous. I've never read an op note for an open placement for comparison.
I would not consider this an open procedure, as it seems to describe percutaneous insertion and would use 64561. My understanding is they make a small stab with the scalpel just to insert the sheath.

see 3:36