Neuro and Pain Management

L4uniki

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Lexington, KY
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At what rate can we expect reimbursement from CMS for L8680 along with bilateral 63650? It does not seem appropriate to deny all payment for L8680 and only 50% flat for 63650. Any information will be appreciated.
 

mhstrauss

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At what rate can we expect reimbursement from CMS for L8680 along with bilateral 63650? It does not seem appropriate to deny all payment for L8680 and only 50% flat for 63650. Any information will be appreciated.

Are you billing for the provider or the facility? What POS was the procedure performed in?
 

Walker22

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Cumming, GA
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At what rate can we expect reimbursement from CMS for L8680 along with bilateral 63650? It does not seem appropriate to deny all payment for L8680 and only 50% flat for 63650. Any information will be appreciated.

I've been out of Pain Mgmt for a little over a year now, but last I heard CMS was bundling the payment of the L Codes in with 63650 and 63685. Look at the Medicare fee schedule for the allowed amounts.
 

CodingKing

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I've been out of Pain Mgmt for a little over a year now, but last I heard CMS was bundling the payment of the L Codes in with 63650 and 63685. Look at the Medicare fee schedule for the allowed amounts.

Good memory. Google Master CK has found a MLN from 2014

April Quarterly Update for 2014 Durable Medical Equipment, Prosthetics,
Orthotics, and Supplies (DMEPOS) Fee Schedule

https://www.cms.gov/outreach-and-ed...k-mln/mlnmattersarticles/downloads/mm8645.pdf

Specific Coding and Pricing Issues

As part of this update, effective April 1, 2014, HCPCS code L8680 is not included on the
2014 DMEPOS fee schedule file and the coverage indicator is revised to "I" to show it is not
payable by Medicare. Note that:

 For neurostimulator devices, HCPCS code L8680 is no longer separately billable for
Medicare because payment for electrodes has been incorporated in CPT code 63650
Percutaneous implantation of neurostimulator electrode array, epidural.

 CMS established non-facility practice expense inputs for CPT code 63650 in the
Medicare Physician Fee Schedule Final Rule (published November 27, 2013). As a
result, practitioners should not report electrode(s) using code L8680 in conjunction
with a lead implantation procedure furnished in any setting for Medicare.

 Also, this change for code L8680 will be available on the HCPCS Quarterly Update
website at
http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/HCPCS_Quarterly_Update.html on the CMS website.
 
Last edited:

kfrycpc

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Carlisle, PA
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Hello, I've recently starting coding spinal cord stimulators. Can you tell me if the below is correct coding?

1.Insertion of Medtronic permanent spinal cord stimulator, battery and generator under fluoroscopic guidance 63650 x2 for the stimulator and two leads, 63685 for the battery
2.Two Leads: 1 Medtronic advanced battery 2 Medtronic anchor L8680 x 2 for 2 leads and L8699 x 2 for the anchors

Thank you so much in advance!
 
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