Peripheral Stimulator switched to Spinal Cord Stimulator

lcole7465

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I have a patient the doctor placed a peripheral stimulator previously and is not switching to a spinal cord stimulator. The generator from the old stimulator was removed & a new pocket was created for the new spinal stimulator generator. He placed 2 new leads and also routed and connected the leads from the peripheral stimulator and connected them to the new generator.

I'm looking at codes:

63650 x2: SCS leads
63685: SCS generator
64595: Removal of peripheral generator
64585: Revision/Removal of peripheral leads

I don't see that there are any edits that prevent these codes from being billed together.

Any input would be greatly appreciated...
 

dwaldman

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It appears it is correct but one thing to consider is according to AMA CPT Assistant April 2011, they state: "Code 63685 includes the creation of a subcutaneous pocket made to house the stimulator and tunneling of the electrodes to the pocket."
So the disconnecting of the peripheral leads then tunneling them to the new generator might be just included in 63685 without reporting 64585.
 
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