Covered dx for 90791, pre-op neural stimulator

[bridgettemartin]

Anyone have experience with billing 90791 for the pre-op psych eval for Spinal Cord stimulators? My BH Provider tells me the psych eval is a pre-requisite to the surgery. However, none of the pre-op codes (or any Z-codes for that matter) are listed on the LCD for WPS. No pain codes are covered either.

 

[danskangel313]

There's an NCD on CMS's website
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/ncd103c1_Part2.pdf

and here
https://www.cms.gov/medicare-covera...DocID=160.7&from2=search.asp&bc=gAAAAAgAAAAA&

And there's some LCD info for WPS here
https://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx?kq=true
under ID L34616

I don't know if that helps, but at least it's something.