Wiki DBS Second Array Placement

[linda.binon@abbott.com]

Hello,

Physician is asking if when reporting code 61867,
Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of
neurostimulator electrode array in subcortical site (e.g., thalamus globus pallidus,
subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative
microelectrode recording; first array

May he report code 61868 for second array through original burr hole or does code 61868 require additional burr hole to be reported?

From what I am seeing, I believe second burr hole is required, but not finding anything in writing to provide to him.

Thank you,
LBinon

 

[vanmarin]

Per Codify on CPT 61868
"After the placement of a first neurostimulator electrode array, the provider places an additional electrode array on the same site, or he may place the electrode array on a different site. The provider, in the same manner as he used for the initial array, identifies the additional targeted area of the brain using the stereotactic method in which previously taken CT or MRI images are imported into a computer system that provides three dimensional images of the brain. The provider may use the same opening, or he may create another opening in the skull bone to access the identified target areas. He then inserts the electrode array protected in a cannula and approaches the subcortical area to be stimulated. Subcortical refers to the area beneath the brain's outermost layer, called the cortex. He also does intraoperative microelectrode recording at the same time, which involves inserting a microelectrode through the hole for better mapping of the neural structures and localizing the targeted area where he will place the electrode array. He then places the neurostimulator electrode array on its optimal position and ensures that the electrodes are correctly placed by stimulating the area. Finally, he sutures the layers of dural tissue together. He may replace the removed skull bone. He closes and covers the wound with a sterile dressing."