Summary & Overview
CPT 1017T: Follow-up Evaluation of Implanted LES Neurostimulator
CPT code 1017T defines a non-programming follow-up evaluation of an implanted lower esophageal sphincter (LES) neurostimulator pulse generator or transmitter. This code captures encounters where a clinician inspects device function and settings but does not change program parameters. It matters nationally as use of implanted neuromodulation devices for gastroesophageal reflux disease and related disorders increases, creating a distinct category of device-monitoring services that payers must recognize and reimburse appropriately.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service represented by the code, the typical site of service, and what to expect in payer coverage considerations. The publication outlines benchmarks for utilization and reimbursement (where available), recent policy or coding clarifications affecting device follow-up services, and clinical context for when non-programming device evaluations are billed.
The report is intended to help billing managers, clinicians, and compliance staff understand how CPT code 1017T differs from programming or interrogation services, where it fits in service lines for gastroenterology and surgical device clinics, and what documentation elements commonly support billing. Data not available in the input will be clearly noted in relevant sections.
Billing Code Overview
CPT code 1017T describes a follow-up evaluation of an implanted lower esophageal sphincter (LES) neurostimulator pulse generator or transmitter. The provider inspects and assesses the device's operational settings and performance but does not perform any programming changes during the encounter.
Service type: Device follow-up / device evaluation
Typical site of service: Outpatient clinic or device clinic setting, including specialty gastroenterology or surgical follow-up visits focused on implanted neuromodulation devices.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged adult with an implanted lower esophageal sphincter (LES) neurostimulator for treatment of gastroesophageal reflux disease (GERD) who presents for a scheduled device follow-up visit. The patient reports intermittent reflux symptoms controlled with prior device settings, no new alarm indications, and no systemic signs of infection. The clinical workflow includes device interrogation by a trained clinician (gastroenterologist, surgeon, or device clinic nurse/technician under supervision), review of pulse generator status, battery life, lead integrity, lesion impedance or sensing parameters, and documentation of device performance. No programming changes are made. The clinician confirms operational parameters are within expected ranges, discusses symptom status with the patient, documents findings in the medical record, and schedules the next routine follow-up or a separate programming visit if changes are needed. Typical site of service is an outpatient physician office or device clinic; visits may also occur in ambulatory surgical center device clinics when device-specific follow-up clinics are co-located there. Typical modifiers include those for professional services and other situational modifiers when applicable; typical provider specialties performing this service include gastroenterology, thoracic surgery, and general surgery with implant expertise.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day |