Wiki 63650 x 2 - what modifier on the second one?

[Breezy]

This is a question on the hospital outpatient setting side. For the spinal cord stimulator trial with 2 leads, 63650, which modifier would you use for the second one? 51 isn't on the list for the outpatient setting from what I can tell. Would you use a 59 or a 76 maybe?

 

[dwaldman]

I would bill quantity two. It is my understanding the payment for the device is included in the CPT for Medicare so for device intensive codes the multiple surgery reduction would not apply in the understanding that the 2nd lead costed the same as the first. Per Cpt Assistant, 51 on the second line on the physician side with a note stating Placement of second lead is the way the physician claim is accepted and even going as far as not reporting 95972 since the rep in essence is "doing the programming"