dlashua

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Seacoast, Dover NH
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Hi,
I am reaching out for a little guidance in the coding for DBS. From what I have found so far this is done in three stages. Do you report modifier "58" on the procedure codes?

We will be performing Fiducials soon - is this reported with an unlisted code?
The following week we will be performing the lead implantation
I believe the following week is the IPG

Any advice would be greatly appreciated!

Thank you,
Doss
 

dlashua

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Seacoast, Dover NH
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Update - dbs

Now that the procedure has been done and PAID - I wanted to let others know how I coded this in case someone else has the same questions:

Stage 1 - Fiducials
So for tracking purposes only I used 64999 - $0 - Stage 1 of DBS - Placement of Fiducials - non-billable per AMA & CMS guidance.

Stage 2 - Lead Implantation - This is a unilateral code so be sure to pay attention to laterality
61867-50

Stage 3 - Insertion pulse generator - this code is selected by the number of arrays - ours was for 2
61886-58

I hope this information is helpful to another coder.

Dorothea Lashua, CPC
 
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Wichita
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dbs - cms rules

I have concluded the same things as you thus far, but I can only find documentation from AMA stating that fiducials are bundled in DBS. Have tried searching CMS a multitude of ways - where were you able to do your research on this topic? Any guidance on documentation for our physician would be helpful, thank you!
 
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