Neurosurgery Coding Alert

You Be the Coder:

Bill for Open Procedure in Paddle Placement

Question: Is this what I would use for this case? Patient has complex regional pain syndrome involving left lower extremity starting in the lower portion and spreading to the medial thigh region. He was offered a spinal cord stimulator with a trial of paddle lead placement. Our billing company says because this was a "trial", it is not billable to his insurance. We don't agree. Please advice and offer CPT® codes for this.Ohio SubscriberAnswer: You report 63655 (Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural) if your surgeon does a laminectomy to implant the spinal cord stimulator. Spinal cord stimulation can be achieved by two procedures. The first one is the percutaneous method and the second one is an open surgical technique. Most providers prefer the percutaneous method for trials as it is less invasive. In fact, the percutaneous method is widely used for trials as well as permanent implants. [...]
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