Wiki Ptns - How are the treatments

[efuhrmann]

How are the treatments using PTNS coded in 2011. My physician is using 95971 which I am not sure he should be coding. What exactly is this code describing and is it appropriate to use? What documentation supports it's use?

 

[micalbee65]

Prior to 2011 AUA and Medicare recommended using an unlisted code 64999.
New for 2011 is the CPT code 64566 for PTNS.
For Northern California there are Medicare coverage guidelines and the LCD # is L31287.
Hope this helps,
Bonnie

 

[bill2doc]

Bonnie, can you direct me where to find this doc L31287, I tried a search by LCD and I cannot pull it up. I too bill for N.Cal and I'm not sure if I can continue to include 95971 w/ the new 64566. Thank you!

 

[jackiep]

CPT® Code64566 describes percutaneous tibial nerve stimulation (PTNS) delivered via the Urgent®PC Neuromodulation System. It includes the office time, equipment, procedure, and programming. No additional codes should be used to describe the procedure.

95971 is programming (interoperative or subsequent) for a neurostimulator. The 2011 CPT Code book states "Do not report 64566 in conjunction with 64555, 95970-95972."

As for the LCD for northern California, you can search by the LCD number L31287 at the Medicare Coverage Database. Just enter it in the "Document ID" search box.

Jackie Pierson
Reimbursement Specialist
Uroplasty, Inc.