CPT® Code 0784T

Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed

The procedure described by CPT® Code 0784T involves the insertion or replacement of a percutaneous electrode array that is specifically designed for spinal applications. This device is equipped with an integrated neurostimulator, which is a sophisticated tool that enables patients to manage their pain by delivering low-level electrical impulses directly to the spinal cord. The use of a handheld remote control allows patients to adjust the stimulation as needed, providing a non-invasive option for alleviating intractable back and/or leg pain. The insertion of this device follows a successful trial placement of a percutaneous spinal stimulator electrode array, ensuring that the patient has responded positively to the initial stimulation before proceeding with the permanent implantation. The procedure typically begins with the creation of a small incision in the lower back, near the buttocks, or in some cases, the abdomen. This incision allows for the formation of a subcutaneous pocket where the neurostimulator generator will be placed. Imaging guidance, specifically fluoroscopy, is utilized during the procedure to accurately position the electrode array into the epidural space, which is the area between the spinal cord and the vertebrae. The correct placement is confirmed by testing for impedance and the presence of paresthesia, a tingling sensation that indicates the stimulation is effectively replacing the perception of pain. Once the optimal position is achieved, the neurostimulator generator is secured in the pocket and sutured into place, followed by irrigation and layered closure of the wound. In cases where the device needs to be replaced, the procedure is performed similarly, starting with the removal of the existing device, which may be necessary due to malfunction, breakdown, or depletion of battery life.