Neurology & Pain Management Coding Alert

Question:What code should we submit for trial stimulator implantation? Should we bill for only the surgical portion and let the supplying company bill for the equipment? Connecticut Subscriber Answer:You have two code choices for the stimulator lead insertion, depending on the anatomic location of the trial placement: 63650 (Percutaneous implantation of neurostimulator electrode array, epidural) for the dorsal column / spinal cord stimulation and 64555 (Percutaneous implantation of neurostimulator electrodes; peripheral nerve [excludes sacral nerve]) for peripheral nerve stimulation. Typically each lead/array/catheter used in spinal cord or peripheral nerve stimulation has multiple electrode contacts. However, billing is based on one unit of service for each lead/array/catheter inserted, not each electrode contact. For example, if your physician percutaneously inserted two trial epidural octrode leads (8 contact electrodes each), you would code 63650 and 63650-51 for the insertion. Even though the code description for peripheral nerve stimulator placement includes the term "electrodes," [...]