Neurosurgery Coding Alert

New codes 95978/95979 mean revisions for 95971-97973 When billing for electronic analysis of implanted neurostimulators, you'll have to be extra careful about terminology from now on, because CPT 2005 will add two new, time-based codes for these procedures:

95978 - Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; first hour

+ 95979 - ... each additional 30 minutes after first hour (list separately in addition to code for primary procedure). The new codes reflect that deep brain stimulator reprogramming is more complex, risky and time- consuming than reprogramming spinal and peripheral stimulators, says a neurologist who serves as a member of the CPT advisory panel.

With the two new codes describing deep brain neurostimulators, the AMA has revised 95971-95973 to eliminate references to brain neurostimulators:

95971 - Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple spinal cord, or peripheral (i.e., peripheral nerve, autonomic nerve, neuromuscular) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming

95972 - ... complex spinal cord, or peripheral (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, first hour

+95973 - ... complex spinal cord, or peripheral (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, each additional 30 minutes after first hour (list separately in addition to code for primary procedure). Revision Makes a Difference in Language Only You'll also notice revisions to four existing insertion/replacement codes for neurostimulators:

61885 - Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array

61886 - Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to two or more electrode arrays

63685 - Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling

64590 - Insertion or replacement of peripheral neurostimulator pulse generator or receiver, direct or inductive coupling.

In all cases, CPT has replaced the phrase "incision and subcutaneous placement of" with "insertion or replacement of" the neurostimulator equipment. The wording change clarifies that the code can apply to pulse generators the surgeon places either during the initial surgery or those he replaces at a later time.