CPT 0910T: Explantation of Integrated Vagus Nerve Neurostimulation Device - OpenPayer

Summary & Overview

CPT 0910T: Explantation of Integrated Vagus Nerve Neurostimulation Device

CPT code 0910T denotes the surgical removal (explantation) of an integrated neurostimulation device from the vagus nerve. This procedure is clinically significant for patients with implanted vagus nerve stimulation systems who require device removal due to infection, device malfunction, therapy discontinuation, or revision surgery. Nationally, accurate coding for device explantation affects clinical documentation, utilization monitoring, and appropriate claims processing for surgical and device-related services.

Key payers commonly involved in coverage and claims for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coding context, expected sites of service, and the clinical scenarios that typically lead to explantation. The publication also summarizes benchmarks and payer coverage patterns, highlights relevant policy considerations affecting payment and prior authorization, and provides clinical context to support correct code selection and documentation.

This resource is intended for coding professionals, surgical departments, billing teams, and policy analysts seeking a practical, nationally focused reference on CPT code 0910T, its clinical application, and the payer landscape relevant to neurostimulation device explantation.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0910TCPTneurostimulationvagus-nervedevice-explantationsurgeryambulatory-surgeryhospital-procedures

Billing Code Overview

CPT code 0910T describes the surgical removal of an integrated neurostimulation device from the vagus nerve. This procedure involves explantation of an implanted vagus nerve stimulation (VNS) system that is integrated with neural tissue and surrounding structures.

Service type: Surgical removal / explantation of an implanted neurostimulation device
Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgery center, depending on clinical complexity and patient condition

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with an implanted vagus nerve neurostimulation system being evaluated for device explantation due to infection, device malfunction, poor therapeutic response, lead erosion, or need for MRI incompatible hardware removal. The workflow begins with preoperative evaluation by a neurosurgeon or otolaryngologist with review of device history, indication (e.g., refractory epilepsy or treatment-resistant depression), imaging to localize lead and generator, and assessment for infection. Preoperative consent documents risks of nerve injury, dysphonia, or cough. On the day of service the patient presents to an ambulatory surgery center or hospital operating room; anesthesia (general) is administered. The surgeon identifies and carefully dissects to the vagus nerve and removes the integrated neurostimulation lead(s) and generator per device-specific technique. Intraoperative decision-making may include partial vs complete removal if adhesions or scar pose risk; specimens are sent for culture if infection is present. Postoperative recovery includes monitoring for airway or cardiac effects, wound care, and device return documentation. Billing uses 0910T for removal of an integrated vagus nerve neurostimulation device, with additional codes for anesthesia, possible wound cultures, or reimplantation recorded separately.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

CPT 0912T: Vagus Nerve Stimulator Check with Simple Programming Adjustments

cpt-0908t-vagus-nerve-neurostimulation-implantation

CPT 0908T: Open Vagus Nerve Neurostimulation Device Implantation

cpt-0909t-vagus-nerve-neurostimulator-replacement

CPT 0909T: Vagus Nerve Neurostimulator Replacement

cpt-0911t-vagus-nerve-neurostimulation-device-check

CPT 0911T: Vagus Nerve Neurostimulation Device Electronic Check

Taxonomy Code	Specialty	Notes
207RC0000X	Neurological Surgery	Neurosurgeons commonly perform vagus nerve stimulator explantation.
207RH0000X	Otolaryngology	Otolaryngologists/head and neck surgeons may perform removal when cervical access is required.
2086S0122X	Psychiatry (Interventional)	Psychiatrists with procedural training may be involved in device management decisions for depression indications.
2084N0400X	Neurology	Neurologists coordinate care for epilepsy indications and may perform or co-manage removals in specialized centers.
208D00000X	Surgical Pain Management	Pain specialists with surgical privileges may be involved in device removal in select programs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G40.909`	Epilepsy, unspecified, not intractable, without status epilepticus	Epilepsy is a primary indication for vagus nerve stimulation; device removal may occur for malfunction, infection, or lack of efficacy.
`G40.901`	Epilepsy, unspecified, intractable, without status epilepticus	Represents refractory epilepsy patients who originally received VNS; explantation may be required for complications or device failure.
`F33.9`	Major depressive disorder, recurrent, unspecified	Treatment-resistant depression is an indication for VNS; removal may follow infection or intolerance.
`T85.89XA`	Other mechanical complication of other internal prosthetic device, implant and graft, initial encounter	Used when the device malfunctions or mechanical failure prompts removal.
`T81.4XXA`	Infection following a procedure, initial encounter	Applied when postoperative or device-related infection is the reason for explantation.
`L02.91`	Cutaneous abscess, unspecified site	Localized abscess at the implant site may require device removal and debridement.
`Z45.2`	Encounter for adjustment and management of implanted device	Relevant for the pre- and postoperative management pathway though not a direct explant indication.

Note: These codes are commonly associated with indications and complications leading to use of 0910T.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19280`	Revision or removal of implanted neurostimulator pulse generator or receiver, direct or inductive coupling	May be reported when the generator component is removed/revised at a separate site or when device design differs from integrated vagus nerve system.
`64585`	Incision for implantation of cranial neurostimulator electrodes; Percutaneous placement (for neuromodulation leads)	Related to initial implantation procedures and used in the overall device care timeline; not for explant but relevant to implantation history.
`61886`	Implantation or replacement of cranial neurostimulator electrode array; intracranial	Represents implantation codes for other neuromodulation systems that may be part of a patient's prior device history.
`36415`	Collection of venous blood by venipuncture	Often performed perioperatively for labs, including cultures or preoperative testing supporting `0910T` when infection is suspected.
`87070`	Culture, bacterial isolate, identification and antimicrobial susceptibility testing	Used when surgical site or device cultures are obtained during explantation for suspected infection.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or service	Used to bill for extra disposable items specific to the explant procedure if payer allows separate charge.

Note: Data not available in the input for any additional related CPT codes beyond those listed.

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