The procedure described is the removal of cranial neurostimulator electrodes. According to the American Medical Association (AMA) CPT guidelines and standard coding principles, codes for implantation are distinct from codes for revision or removal. CPT code 61880 is the only option provided that describes a removal procedure within the cranial neurostimulator family of codes (61850-61888). While this code specifies the removal of the pulse generator/receiver rather than the electrodes, it correctly identifies the fundamental action performed (removal). Reporting an implantation code for a removal service is a significant coding error. Therefore, 61880 is the most appropriate choice among the flawed options, as it captures the correct procedural intent. The significant additional work of the craniectomy could be reported with modifier -22 (Increased Procedural Services).

Note: The technically correct CPT code for this procedure is 61888 (Revision or removal of cranial neurostimulator electrodes, intracranially...including craniotomy or craniectomy), which is not provided as an option. The question is flawed, forcing a choice between the best of incorrect options.

A. 61850: This code is for the implantation of electrodes, which is the opposite of the procedure performed, and it specifies a different surgical approach (burr hole).

C. 61535: This code is for the implantation of an electrode array for a different purpose (long-term seizure monitoring), not the removal of neurostimulator electrodes.

D. 61860: This code is for the implantation of electrodes. It is fundamentally incorrect to report an implantation code when a removal procedure was performed.

1. American Medical Association. (2023). CPT® 2023 Professional Edition.

Section: Surgery/Nervous System

Skull

Meninges

and Brain

pages 450-451. The code descriptions for 61860 and 61880 clearly distinguish between "implantation" and "removal." The guidelines implicitly separate these procedures

meaning one cannot be substituted for the other. The existence of a specific code for removal of electrodes

61888

further solidifies that implantation codes are inappropriate for this service.

2. AAPC. (2023). Official CPC Certification Study Guide.

Chapter 11: Nervous System. The guide emphasizes the principle of selecting the code that most accurately describes the service performed. It explicitly separates the coding for implantation (e.g.

61860) from revision or removal (e.g.

61880

61888)

reinforcing that these actions are not interchangeable for coding purposes. Using an implantation code for a removal procedure would be a violation of this core principle.