CPT® Code 64561

Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed

The procedure described by CPT® Code 64561 involves the percutaneous implantation of a neurostimulator electrode array specifically targeting the sacral nerve through transforaminal placement. This technique is primarily utilized for the treatment of various voiding dysfunctions, which may include conditions such as urge incontinence, urgency, frequency, and nonobstructive retention. The sacral nerves, which play a crucial role in bladder control and pelvic floor function, are accessed via the sacral foramen. The identification of these anatomical landmarks can be achieved through the use of bony landmarks or with the assistance of imaging guidance, such as fluoroscopy, to ensure precise placement of the electrode array. Prior to the procedure, the skin over the sacral area is meticulously prepared, and a local anesthetic is administered to minimize discomfort during the intervention. The percutaneous approach involves the use of an electrically insulated spinal needle, which is carefully advanced through the skin and deeper tissues until it reaches the targeted sacral foramen. Once the needle is in position, a power source is connected, and stimulation is applied to evaluate motor and sensory responses. This step is critical as it allows the physician to adjust the needle's position until the desired response is achieved, indicating optimal placement of the electrode. After confirming the correct positioning, the needle is disconnected from the power source, and the electrode array is introduced through the needle's lumen. The electrode is then positioned adjacent to the sacral nerve, and the needle is subsequently removed, leaving the electrode array in place. Finally, the electrode array is connected to an external generator or receiver, completing the implantation process.