Hypoglossal  nerve stimulator
New Category III codes

February 2017 - Vol. 36, No. 01

New Category III codes have been established in the Current Procedural Terminology (CPT®) 2017 code set to report implantation of a hypoglossal nerve stimulation system that includes the placement of a chest wall sensor. Previously, this entire service was reported with code 64999, Unlisted procedure, nervous system (see CPT Assistant September 2011). This article provides an overview of these changes.

New Category III codes

The new codes describe the implantation, revision, replacement, or removal of the chest wall sensor(s) attached to a cranial nerve neurostimulator electrode array and pulse generator for the treatment of selected patients with obstructive sleep apnea. Note that these new codes will be effective for use on January 1, 2017, and they are available  on the CPT Category III website at https://www.ama-assn.org/practice-management/cpt-category-iii-codes.

Publication of the Category III codes to the CPT website takes place on a semiannual basis when the codes have been approved by the CPT Editorial Panel. The full set of temporary Category III codes for emerging technology, services, procedures, and service paradigms are published annually in the code set for each CPT publication cycle. As part of the electronic distribution, there is a six-month implementation period from the initial release date (i.e., codes released on January 1 are eligible for use on July 1, and codes released on July 1 are eligible for use on January 1).

Category III code 0466T is an add-on code to report in conjunction with code 64568 for the primary placement of a hypoglossal nerve stimulator and generator that includes a chest wall sensor electrode or electrode array. If the surgeon were to insert a hypoglossal nerve stimulator that does not require or include a chest wall sensor electrode or electrode array, then only code 64568 may be reported.

Codes 0467T and 0468T, which are not add-on codes, may be reported for either the revision and replacement or removal of the chest wall sensor electrode or electrode array, respectively. If the hypoglossal nerve stimulator array and generator were also revised, replaced, or removed, existing codes 64569 or 64570 may be reported.

+λ0466T Insertion of chest wall respiratory sensor electrode or electrode array, including connection to pulse generator (List separately in addition to code for primary procedure).

(Use 0466T in conjunction with 64568.)

 λ0467T Revision or replacement of chest wall respiratory sensor electrode or electrode array, including connection to existing pulse generator

(Do not report 0467T in conjunction with 0466T, 0468T.)

(For revision or replacement of cranial nerve [e.g., vagus nerve] neurostimulator electrode array, including connection to existing pulse generator, use 64569.)

 λ0468T Removal of chest wall respiratory sensor electrode or electrode array

(Do not report 0468T in conjunction with 0466T, 0467T.)

(For removal of cranial nerve [e.g., vagus nerve] neurostimulator  electrode array and pulse generator, use 64570.)