Summary & Overview

CPT 0819T: Revision or Removal of Posterior Tibial Nerve Neurostimulation System

CPT code 0819T denotes the revision or removal of a subfascially implanted integrated neurostimulation system that targets the posterior tibial nerve to treat bladder dysfunction. This procedure can include device analysis, programming, and imaging guidance and is performed when device malfunction, complications, or therapy discontinuation necessitate revision or explantation. Nationally, the code is significant as use of implantable neuromodulation for lower urinary tract dysfunction has grown, raising coverage, coding, and payment considerations across public and commercial payers.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coverage and claim considerations, typical sites of service such as hospital outpatient departments and ambulatory surgery centers, and clinical context around posterior tibial nerve stimulation devices used for bladder dysfunction. The publication summarizes available benchmarks and common billing practices, highlights relevant policy updates where applicable, and clarifies coding nuances for device revision and removal services. Data not available in the input is noted where applicable, and the focus remains on delivering a practical, national-level guide to understanding CPT code 0819T and its role in managing implanted neurostimulation systems for bladder dysfunction.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0819TCPTneurostimulationposterior tibial nervebladder dysfunctiondevice removalsurgical revisionoutpatient surgery

Billing Code Overview

CPT code 0819T describes the revision or removal of a subfascially implanted integrated neurostimulation system that stimulates the posterior tibial nerve for treatment of bladder dysfunction. The service may include device analysis, programming, and imaging guidance as part of the procedure.

Service type: Surgical removal or revision of an implanted neurostimulation device, including associated device interrogation and programming
Typical site of service: Hospital outpatient surgical suite or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 62-year-old woman with refractory overactive bladder and urinary urgency-frequency who previously received a subfascially implanted integrated neurostimulation system targeting the posterior tibial nerve presents with device-related pain and loss of efficacy. After clinical evaluation and imaging confirms lead migration and generator malfunction, the urology or pain management team schedules removal and possible revision of the subfascial stimulator. Preoperative workup includes focused history, medication reconciliation, anticoagulation management, informed consent discussing risks of explantation and re-implantation, and baseline urinary symptom assessment.

Intraoperative workflow typically occurs in an ambulatory surgery center or hospital operating room under monitored anesthesia care or general anesthesia. The procedure includes surgical exposure of the subfascial pocket, identification and dissection of leads and generator, removal or revision of the lead and pulse generator, intraoperative device analysis and programming as indicated, and fluoroscopic or ultrasound imaging guidance when needed. Postoperative care includes device interrogation, programming, wound care, short recovery observation, and follow-up to assess urinary symptoms and wound healing.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or complexity is substantially greater than typical for (document medical reason and extent).

Taxonomy Code	Specialty	Notes
`207P00000X`	Physical Medicine & Rehabilitation	Many PM&R physicians manage neuromodulation devices for bladder dysfunction and perform revisions.
`208800000X`	Urology	Urologists frequently evaluate bladder dysfunction and perform implantation or explantation of neuromodulation systems.
`2084P0800X`	Pain Medicine	Pain medicine specialists or interventional pain physicians commonly manage neurostimulation devices and perform surgical revisions.
`207K00000X`	Neurology	Neurologists may be involved in device programming and symptom assessment; some perform implant-related procedures in multidisciplinary settings.

ICD-10 Code	Description	Clinical Relevance
`N32.81`	Overactive bladder	Overactive bladder is a primary indication for posterior tibial nerve stimulation and may prompt device revision or removal for malfunction or infection.
`N31.9`	Neurogenic bladder, unspecified	Neurogenic bladder may be treated with neuromodulation when conservative therapies fail; device removal/revision is performed for complications or inefficacy.
`N39.3`	Stress incontinence (female)	In some cases posterior tibial nerve stimulation is used for refractory urinary incontinence symptoms; revision may be required.
`R35.0`	Frequency of micturition	Urinary frequency is a common presenting symptom leading to neuromodulation therapy and subsequent device management procedures.
`N30.90`	Cystitis, unspecified, without hematuria	Recurrent urinary tract symptoms or infection related to device or underlying bladder pathology can necessitate device removal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0414T`	Percutaneous posterior tibial nerve stimulation; single treatment	Used as an adjunct or alternative therapy in diagnostic or trial stimulation prior to permanent implant or after explantation.
`64555`	Percutaneous implantation of neurostimulator electrode array; peripheral nerve (e.g., sacral, posterior tibial)	May be used for implantation of peripheral nerve stimulation leads when placing or revising leads associated with `0819T`.
`64561`	Revision or removal of peripheral neurostimulator pulse generator or receiver; subcutaneous or subfascial	Related generator revision/removal codes; used when generator revision is performed in conjunction with lead removal.
`95972`	Electronic analysis of implanted neurostimulator pulse generator system (reprogramming), one hour	Captures intraoperative or postoperative device analysis and programming time frequently performed with `0819T`.
`76000`	Fluoroscopy (separate procedure), imaging guidance	May be reported when imaging guidance such as fluoroscopy is used during lead localization, removal, or re-implantation.

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