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Vagal Nerve Stimulator- replacement of pulse generator

  1. Default Vagal Nerve Stimulator- replacement of pulse generator
    Medical Coding Books
    I don't have much experience with these, so I hope someone out here does. I have received 2 different answers. One coder states this should be billed as
    64569 -51 dx. V53.09
    The other coder states that it should be
    61886 dx. V53.09

    I'm completely confused now.

    Vagal nerve stimulator at end-of-life.

    Replacement of pulse generator.

    The patient was brought to the operating room. After attainment of sufficient MAC anesthesia, she was pretreated with antibiotics and prepped and draped in the usual sterile fashion. We injected with 0.25% solution of Marcaine with epinephrine and then made an incision over the previous pulse vagal nerve stimulator. We swabbed out the pocket with Betadine and then removed the old generator and replaced it with a Cyberonics, model 102R connecting the old leads to the new header making sure that we tightened it down to the ratchets using the enclosed Allen wrench. We then dropped the pacer back into the pocket, swabbed it once again with Betadine. Closed with deep sutures of 3-0 Vicryl followed by running subcuticular suture of 4-0 Vicryl and then surgical adhesive. The patient tolerated the procedure quite well.

  2. Default
    I'd suggested 61885 as described in CPT's illustration for codes 64568-64570 (p.330 AMA's prof edition). States "Replacement of cranial nerve pulse generator(61885)".

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