64569
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
10.73
Facility
$746.18
Non-Facility
$746.18
Documentation Required
- To bill for these (denied) procedures, providers must report CPT code 64999 for both trial and permanent electrode-array insertions and indicate whether the procedure is a trial or permanent in the claim narrative/comment field adjacent to CPT 64999.
- For Part B claims enter 1 unit of service (UOS) and include the text 'Peripheral Nerve Field Stimulation', 'PNFS', 'Peripheral Subcutaneous Field Stimulation', or 'PSFS' adjacent to CPT 64999 and whether the procedure is permanent or trial in the comment/narrative field (e.g., Loop 2400 or SV101-7 for 5010A1 837P; Item 19 for paper claims).
- For Part A claims enter 1 UOS and include the text 'Peripheral Nerve Field Stimulation', 'PNFS', 'Peripheral Subcutaneous Field Stimulation', or 'PSFS' adjacent to CPT 64999 and whether the procedure is permanent or trial in the comment/narrative field (e.g., Line SV02-7 for 837I electronic claims; Block 80 on the UB-04 form).
Key Coverage Criteria
- Use CPT 64582 for open implantation of a hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array for treatment of obstructive sleep apnea (OSA).
- Use CPT 64568 for open implantation of a cranial nerve (e.g., vagus nerve) neurostimulator electrode array and pulse generator for treatment of obstructive sleep apnea (OSA).
- Report CPT 64583 for revision or replacement of a hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to an existing pulse generator.
- Report CPT 64569 for revision or replacement of a cranial nerve (e.g., vagus) neurostimulator electrode array, including connection to an existing pulse generator.
- Report CPT 64584 for removal of a hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode array.
- Report CPT 64570 for removal of a cranial nerve (e.g., vagus nerve) neurostimulator electrode array and pulse generator.
20 Active Policies
L35490 — Category III Codes
J05
A57944 — Billing and Coding: Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea
J05
L38528 — Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
J05
AETNA-CPB-0406 — Tinnitus Treatments
A55530 — Billing and Coding: Peripheral Nerve Stimulation
Related Codes
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