knitschelm
New
Unique tiny sacral nerve stimulator billing question:
This is a percutaneous implantable micro stimulator device w/o battery, no leads need to be connected, no pulse generator pocket needs to be created.
Powered externally.
The device is considered to be an all-in-one, Micro implant with integrated circuit (IC) for pulse control, and electrodes, entirely assembled within a 2-mm diameter, 3.5-mm height device small enough to fit inside a catheter.
If the electrodes and the generator are all inside the device, and the physician makes an incision for insertion by an introducer needle, would we bill both the following?:
• 64561 Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed -and-
• 64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling
Basic procedure micro-implant for Sacral Nerve Stimulation:
o Physician uses scalpel to do a very small starter incision adjacent to the needle, followed by insertion of an introducer/dilator/sheath.
o Both the dilator and needle are then withdrawn providing clear access to the target anatomy just adjacent to the sacral nerve.
o All-in-one device is placed adjacent to the sacral nerve by advancing it through the sheath. Physician has the option of using fluoroscopy throughout this procedure as tooling and implant are radiopaque
Any advice is greatly appreciated!
This is a percutaneous implantable micro stimulator device w/o battery, no leads need to be connected, no pulse generator pocket needs to be created.
Powered externally.
The device is considered to be an all-in-one, Micro implant with integrated circuit (IC) for pulse control, and electrodes, entirely assembled within a 2-mm diameter, 3.5-mm height device small enough to fit inside a catheter.
If the electrodes and the generator are all inside the device, and the physician makes an incision for insertion by an introducer needle, would we bill both the following?:
• 64561 Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed -and-
• 64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling
Basic procedure micro-implant for Sacral Nerve Stimulation:
o Physician uses scalpel to do a very small starter incision adjacent to the needle, followed by insertion of an introducer/dilator/sheath.
o Both the dilator and needle are then withdrawn providing clear access to the target anatomy just adjacent to the sacral nerve.
o All-in-one device is placed adjacent to the sacral nerve by advancing it through the sheath. Physician has the option of using fluoroscopy throughout this procedure as tooling and implant are radiopaque
Any advice is greatly appreciated!