Wiki Neurostimulator Trial lead removal

[Mary Ellen Hlavaty]

Does anyone bill for removal of neurostimulator leads for trial? We usually place leads 63650 for 5 day trial and remove. Currently, we do not charge for removal because it is done within global period.
Dr's colleague said they always bill 63660+58 since removal was plannned procedure and within the global period. Does it matter if trial was failed and therefore no permanent placement of leads/pulse generator will be implanted?
Global period changed from 90 days to 10 days as of 1/1/09, but scope remains the same.
Are we missing out on opportunity to bill or is this service inclusive?

 

[magnolia1]

Are "permanent" leads being placed at the time the "trials" are being removed?

 

[Mary Ellen Hlavaty]

No - leads are always temporary placement and removed. If the trials is a success, they schedule permanent placement 4-6 weeks later (after healing) and we again bill 63650+58. If unsuccessful, we just remove the leads during a postop visit.

 

[magnolia1]

Mmmmmm.......

The surgeons that perform this type of procedure at the facility where I work replace the trail lead with permanent lead(s) at the same operative session (if the trial was a success), for which I only code 63650.

I think you would be okay coding 63660 subsequent to the placement if the leads were removed and not replaced.

 

[Mary Ellen Hlavaty]

Thanks for the imput ... I am unsure of implementing this billing "opportunity" but I don't to be under billing our services either.

I am more confident of billing for lead removal for failed trials versus prior to permanent implantation occurring well after the 10 day global period.

I appreciate the help.