CPT® Code 63663

Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed

The CPT® Code 63663 refers to the procedure of revising and potentially replacing spinal neurostimulator electrode percutaneous arrays. This procedure is part of a spinal cord stimulation system, which is utilized primarily for the management of chronic back and/or leg pain. The underlying mechanism involves the electrical stimulation of the spinal cord, which activates pain-inhibiting neurons, thereby alleviating pain sensations and often inducing a tingling sensation that can mask the perception of pain. In this specific procedure, a revision is performed on the electrode array that is situated in the epidural space. The process begins with the use of fluoroscopic guidance, which is a type of imaging that allows the physician to visualize the internal structures in real-time. A small incision is made at the site of the electrode array, allowing access to the array for exploration. The physician assesses whether the electrode array requires repositioning or complete replacement. If repositioning is necessary, any sutures securing the array are removed, and the array is adjusted to achieve optimal pain control. Conversely, if the array needs to be replaced, it is removed as a separate procedure. A new electrode array is then inserted into the epidural space and secured with sutures. Following the placement, the patient is awakened to test the revised or new array, ensuring proper placement and confirming that the electrode array does not cause any pain. The neurostimulator is then tested at various settings to determine the most effective configuration, which will be used to program the pulse generator or receiver that will be implanted in a separate procedure. Finally, the lead wires from the electrode array are tunneled to the pocket where the pulse generator or receiver will be located, and they are connected to the generator or receiver to complete the setup of the spinal cord stimulation system.