Wiki 63650-Percutaneous implant of Neurostimulator Electrodes

[maebelle@gmail.com]

One of our doctors is billing 63650 for placement of neurostimulator electrodes for treatment of chronic migraines. Currently, we have only billed to Medicare and are receiving denials stating that the patient has not undergone a psychological screening prior to the procedure. Does anyone else have any experience with billing this CPT code with Medicare? We treated one other patient with the neurostimulator for chronic post-operative pain and Medicare paid, no questions asked. Obviously, it has something to do with the diagnosis codes, but I'm having trouble finding information about what diagnosis codes are approved for this code. Thanks in advance for any info!

 

[MBlack]

Take a look at the range of codes 64550-64595, "peripheral", not along the spine. 63650 is for epidural, along the spine, and I'm not sure if maybe yours are placed elsewhere, maybe the back of the head, or...just wanted to double check.

 

[catrinaquin]

63650

Only chronic pain DX codes, 338.X are covered. One of these has to be the primary DX. Refer to the following links:

http://www.medicarepaymentandreimbursement.com/2011/09/spinal-cord-stimulation-dorsal-column.html

http://professional.medtronic.com/wcm/groups/mdtcom_sg/@mdt/@neuro/documents/documents/scs-codes.pdf

 

[acoates0619@yahoo.com]

63650

I agree with both of the other posts for this questions, but for the chronic migraine, we have used 346.7_ and gotten it paid by Medicare and Medicaid with the patient having a neuro-psych evaluation before the procedure. We have integrated this into our precert/auth process. We order, precert and refer for this eval, then the neurologist sends the report. We have had no issues with payment if the proper procedure and dx code is used.

 

[lacarolshipman]

Does any one know the criteria for Spinal Cord Stimulation that InterQual requires? or the MCG guidelines? Thanks so much for any help.

 

[SharonCollachi]

Does any one know the criteria for Spinal Cord Stimulation that InterQual requires? or the MCG guidelines? Thanks so much for any help.

Being that they are a paid service, someone who is not connected to them via a paid service wouldn't be able to help. Since you are connected to a paid service (or you wouldn't be asking), you should probably contact InterQual and MCG directly.