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[64], treatment with acetyl-l-carnitine (500 mg twice daily intramuscularly for 10 days followed by 2000 mg daily administered orally for 355 days) resulted in improvement in neurophysiological parameters and pain reduction over a 1-year period [64]

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The commenter noted that CPT code 64596 is an outlier compared to other percutaneous implantation codes (64555, 64575, 64590) that do not have MPPR assignment, and emphasized that the clinical need for multiple integrated neurostimulators is similar to other peripheral nerve stimulation devices where each implant requires additional work and separate device costs