Summary & Overview
CPT 61867: Stereotactic Placement of Neurostimulator Electrode Array
CPT code 61867 describes stereotactic placement of a neurostimulator electrode array into a targeted intracranial site using a three-dimensional coordinate system and intraoperative microelectrode recording. This operative neurosurgical procedure is a core technique for deep brain stimulation and other neuromodulation therapies used to manage movement disorders, certain refractory neurological conditions, and pain syndromes. Nationally, precise coding for this procedure affects reimbursement, clinical registry reporting, and device-related policy decisions.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and payment policies for 61867 influence access to neuromodulation services across inpatient and outpatient surgical settings and interact with device-specific and facility-based rules.
Readers will find a concise overview of the clinical and procedural context for 61867, benchmark expectations for payer coverage, and the policy and billing considerations that commonly arise with image-guided intracranial electrode placement. The publication highlights service setting implications, typical utilization drivers, and areas where payers frequently apply medical necessity criteria or documentation requirements. Data not provided in the input are noted where applicable.
Billing Code Overview
CPT code 61867 describes a stereotactic neurosurgical procedure in which the surgeon creates a skull opening (craniotomy or burr holes) and places a neurostimulator electrode array on a targeted brain site using a three-dimensional coordinate system and intraoperative microelectrode recording. This code represents an operative, image-guided neuromodulation procedure that targets small intracranial structures for therapeutic stimulation.
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Service type: Stereotactic placement of neurostimulator electrode array with intraoperative microelectrode recording (operative neurosurgery)
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Typical site of service: Hospital operating room or ambulatory surgical center (inpatient or outpatient neurosurgical setting)
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Additional notes: Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with medically refractory Parkinson disease presents for stereotactic placement of a deep brain stimulation (DBS) lead targeting the subthalamic nucleus. The neurosurgeon plans a frameless stereotactic craniotomy with intraoperative microelectrode recording to refine target localization and confirm neurophysiologic signatures before permanent electrode placement. The perioperative workflow includes preoperative imaging (MRI with stereotactic planning), anesthesia evaluation (general or monitored anesthesia care), placement of a small bone flap or burr holes, stereotactic guidance to the target using a three-dimensional coordinate system, intraoperative microelectrode recording for physiologic mapping, placement of the neurostimulator electrode array, intraoperative testing of stimulation effects, wound closure, and coordination with a device representative for equipment programming. Postoperative care includes PACU monitoring, neuro checks, immediate postoperative imaging as indicated, and scheduling for implantable pulse generator placement in a later procedure if not performed concurrently.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, and effort substantially exceed the typical for the procedure (document justification). |
23 |