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Vagus nerve blocking (VBLOC) therapy is a medical procedure designed to assist in the treatment of morbid obesity. The vagus nerve, also known as the pneumogastric nerve or cranial nerve X, originates from the brainstem and consists of two branches that extend along the esophagus, bronchi, and major blood vessels, passing through the diaphragm and terminating in the upper part of the stomach. This nerve plays a crucial role in the regulation of hunger and satiety by transmitting signals between the stomach and the brain. In VBLOC therapy, a specialized technique is employed where an intermittent, high-frequency, low-energy electrical stimulus is applied to block the nerve impulses that communicate hunger signals from the stomach and pancreas to the brain. During the procedure, prior to the replacement of the leads and/or neuroregulator, the device is programmed to an 'off' state. The surgical approach involves making a small portal incision in the upper abdomen, through which a trocar is inserted. A pneumoperitoneum is established by insufflating carbon dioxide into the abdominal cavity. Subsequently, two to three additional small incisions are created to facilitate the introduction of surgical instruments. A laparoscope is then introduced through a small incision located just above the umbilicus. The liver is retracted to expose the previously implanted electrode arrays situated at the anterior and posterior esophagogastric junction. If necessary, the existing electrode arrays may be relocated or replaced, ensuring they are positioned correctly around the vagus nerve trunks. The procedure may also involve the removal and replacement of the neuroregulator, which is a critical component of the vagus nerve stimulation system. After the procedure, the neuroregulator is activated and programmed using a transmit coil and an external mobile charging unit, ensuring the device functions correctly to aid in the management of obesity.
© Copyright 2026 Coding Ahead. All rights reserved.
The vagus nerve blocking therapy is indicated for patients suffering from morbid obesity. This condition is characterized by an excessive accumulation of body fat that presents a risk to health, leading to various comorbidities. The therapy aims to assist in weight management by altering the signals of hunger and satiety transmitted by the vagus nerve.
The procedure for vagus nerve blocking therapy involves several critical steps to ensure the effective removal of the vagal trunk neurostimulator electrode array and pulse generator. Initially, the device is programmed to an 'off' state to prevent any unintended stimulation during the surgical process. A small portal incision is made in the upper abdomen, and a trocar is inserted to facilitate access to the abdominal cavity. Following this, a pneumoperitoneum is established by insufflating carbon dioxide, which creates a working space for the surgeon. To allow for the introduction of surgical instruments, two to three additional small incisions are made. A laparoscope is then introduced through a small incision located just above the umbilicus, providing visual access to the surgical site. The liver is carefully retracted to expose the previously implanted electrode arrays located at the anterior and posterior esophagogastric junction. If the procedure necessitates the relocation of the existing electrode arrays, the surgeon will locate and reposition one or both arrays around the vagus nerve trunks as required. In cases where replacement of the electrode arrays is necessary, a skin incision is made over the neuroregulator, allowing for the disconnection and removal of the old lead(s). New lead(s) are then placed, and if the neuroregulator itself requires replacement, it is removed and a new device is implanted. Once the repositioned or new leads are connected to the neuroregulator, they are tested to ensure proper functionality. If new leads have been placed, they are tunneled to the neuroregulator, connected, and tested again. Finally, the neuroregulator is returned to its subcutaneous pocket, which is then closed with sutures. The neuroregulator is activated and programmed using a transmit coil and an external mobile charging unit, completing the procedure.
Post-procedure care involves monitoring the patient for any immediate complications related to the surgery. Patients may experience some discomfort at the incision sites, which is typically managed with standard postoperative care. Recovery time can vary, but patients are generally advised to follow specific guidelines regarding activity levels and wound care to promote healing. Follow-up appointments are essential to assess the functionality of the neuroregulator and to make any necessary adjustments to the programming of the device. Patients should also be educated on the importance of adhering to a healthy lifestyle, including diet and exercise, to maximize the benefits of the vagus nerve blocking therapy in managing their obesity.
| Short Descr | LAPS RMVL VGL ARRY&PLS GEN | Medium Descr | LAPS RMVL NSTIM ELTRD ARRAY & PLS GEN VAGUS NRV | Long Descr | Vagus nerve blocking therapy (morbid obesity); laparoscopic removal of vagal trunk neurostimulator electrode array and pulse generator | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 244 - Gastric bypass and volume reduction |
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| 2022-12-31 | Deleted | Code deleted. For laparoscopic implantation, revision, replacement, or removal of vagus nerve blocking neurostimulator electrode array and/or pulse generator at the esophagogastric junction, use 64999. |
| 2013-01-01 | Added | First appearance in codebook. |
| 2012-01-01 | Added | Added |
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