Hello,
Im looking for some assistance regarding the procedure below.
The Dec 2023 and March 2024 CPT Assistants are confusing me. I am considering the 64561 and 64590 for the PB side.
Also, In 3M, I am coming up with HCPCS code 0796T for the HB side, any help or suggestions are appreciated.
TIA
Pre-Operative Diagnosis: urinary urgency and frequency; urgency incontinence
Post-Operative Diagnosis: same
Procedure: 1. Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance
2. Intraoperative programming, initial
3. Insertion of peripheral neurostimulator pulse generator or receiver, direct coupling (non-recharging device)
Description of procedure:
The patient was identified, placed prone on the operating room table, and underwent induction of monitored anesthesia care. A timeout was performed. The back and peri anal area was prepped and draped in the usual fashion. Fluoroscopy was used to identify landmarks. Her non functioning Axonics recharging battery product was removed by making a right upper buttocks incision over the old implant. The tined lead was also removed intact. That incision was expanded to give room for the next implant.
The S3 sacral foramen was cannulated with a foramen needle on the left side. The external generator was used to illicite the typical neuromotor responses of anal bellows and ipsilateral plantarflexion of the great toe on each side. The tined lead was then inserted into the S3 foramen through the provided trocar. Again the device was tested with good response.
On the right upper buttocks, 1% lidocaine x 10 ml was used total to provide a field block. A transverse incision was made and a subcutaneous pocket was made with electrocautery. The generator was then opened. The tined lead was tunneled over from the left side and the lead was then secured to the battery and locked into place with the provided screwdriver. The non-recharging battery was then inserted into the pouch and it fit nicely. The battery was then interrogated with the external programmer. It registered with resistances in the normal range. The wound was then closed in two layers with 3-0 chromic in the subcutaneous fat and 4-0 monocryl in the skin. Sterile dressings and steri strips were applied.
The patient was then transferred to the recovery room in satisfactory condition. There were no immediate complications
Im looking for some assistance regarding the procedure below.
The Dec 2023 and March 2024 CPT Assistants are confusing me. I am considering the 64561 and 64590 for the PB side.
Also, In 3M, I am coming up with HCPCS code 0796T for the HB side, any help or suggestions are appreciated.
TIA
Pre-Operative Diagnosis: urinary urgency and frequency; urgency incontinence
Post-Operative Diagnosis: same
Procedure: 1. Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance
2. Intraoperative programming, initial
3. Insertion of peripheral neurostimulator pulse generator or receiver, direct coupling (non-recharging device)
Description of procedure:
The patient was identified, placed prone on the operating room table, and underwent induction of monitored anesthesia care. A timeout was performed. The back and peri anal area was prepped and draped in the usual fashion. Fluoroscopy was used to identify landmarks. Her non functioning Axonics recharging battery product was removed by making a right upper buttocks incision over the old implant. The tined lead was also removed intact. That incision was expanded to give room for the next implant.
The S3 sacral foramen was cannulated with a foramen needle on the left side. The external generator was used to illicite the typical neuromotor responses of anal bellows and ipsilateral plantarflexion of the great toe on each side. The tined lead was then inserted into the S3 foramen through the provided trocar. Again the device was tested with good response.
On the right upper buttocks, 1% lidocaine x 10 ml was used total to provide a field block. A transverse incision was made and a subcutaneous pocket was made with electrocautery. The generator was then opened. The tined lead was tunneled over from the left side and the lead was then secured to the battery and locked into place with the provided screwdriver. The non-recharging battery was then inserted into the pouch and it fit nicely. The battery was then interrogated with the external programmer. It registered with resistances in the normal range. The wound was then closed in two layers with 3-0 chromic in the subcutaneous fat and 4-0 monocryl in the skin. Sterile dressings and steri strips were applied.
The patient was then transferred to the recovery room in satisfactory condition. There were no immediate complications