Wiki placement of spinal cord stimulator after lead trial

[suec]

Hello, Can someone clarify the use or not use of modifier 58 on CPT 63685 for facility coding. The procedure: trial leads are placed previously & attached to a external generator. Later a permanent generator is placed and attached to the previously implanted leads. We coded 63685. It was mentioned that modifier 58 should be added because it is a staged procedure done within the postprocedural time frame. Is the global period 10 days for CPT 63650? If the generator is placed within 10 days we use modifier 58 and if it's greater than 10 days no modifier is used? I was given A57709 as a reference. Is this for physicians only or does it apply to hospitals. Claims were paid without issue and without modifier 58. Thanks so much

 

[linda.binon@abbott.com]

SCS perm codes do not normally require a 58 modifier because it is understood that the patient must undergo a trial SCS and, if trial provides at least 50% reduction in pain, perm SCS is implanted. No separate charge is reported for removal of trial leads.

 

[medlcg79]

Hello, Can someone clarify the use or not use of modifier 58 on CPT 63685 for facility coding. The procedure: trial leads are placed previously & attached to a external generator. Later a permanent generator is placed and attached to the previously implanted leads. We coded 63685. It was mentioned that modifier 58 should be added because it is a staged procedure done within the postprocedural time frame. Is the global period 10 days for CPT 63650? If the generator is placed within 10 days we use modifier 58 and if it's greater than 10 days no modifier is used? I was given A57709 as a reference. Is this for physicians only or does it apply to hospitals. Claims were paid without issue and without modifier 58. Thanks so much

Modifier 58 does not apply to facility coding/billing. This modifier is used for the professional component within the global period.

 

[linda.binon@abbott.com]

First Coast (FL MAC) Article A57709 does state this instruction, but, as far as I have seen, this is the only MAC that has this instruction.

 

[suec]

Thank you all for the information. Very helpful!