Effective October 1, 2010, two new codes have been created to describe cranial implantation or replacement of neurostimulator pulse generator (01.20) and the removal of cranial neurostimulator pulse generator (01.29).
The RNS® System is a device designed for the treatment of medically intractable (partial or focal) epilepsy and includes both implantable and external products. The system involves a cranial neurostimulator that is responsive, has the ability to detect new-onset seizures, and apply stimulation at a seizure focus to suppress the detected seizure.
The implantable workings of the system include the RNS neurostimulator as well as depth leads and cortical strip leads. The neurostimulator is a programmable, battery powered, microprocessor-controlled device that delivers a short train of electrical pulses to the brain through implanted leads. In treating epilepsy, the RNS neurostimulator is designed to detect abnormal electrical activity in the brain and respond by delivering electrical stimulation to stabilize brain activity before the patient experiences a seizure. The neurostimulator is implanted in the cranium and connected to one or two leads that are implanted near the patient's seizure focus.
The external device includes the programmer, a laptop computer with proprietary software, which has a wand and telemetry interface enabling communication with an implanted RNS neurostimulator. Physicians use the programmer to noninvasively program the detection and stimulation parameters of the device. Other elements include the capability to assess the patient's electrical brain activity (electrocorticogram or ECoG) in real-time and the ability to upload the patient's stored data.
New code 01.20 Cranial implantation or replacement of neurostimulator pulse generator Code also any associated lead implantation (02.93) Excludes: implantation or replacement of subcutaneous neurostimulator pulse generator (86.94 -86.98) New code 01.29 Removal of cranial neurostimulator pulse generator