Wiki Removal of array(s)

[dwaldman]

63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed

From CPT Assistant
"Answer: For both the 63650-63660 and 64553-64581 series of codes, placement of any additional electrode catheter(s) or plate(s)/paddle(s) should be separately reported by appending either modifier 51 (same anatomic site) or modifier 59 (different anatomic site) to the appropriate code."

I had been told that 63660 was billed per lead removed, but when I looked at the CPT Assistant article, they are referring to the "placement" of leads and since 63660 used to include revision I was wondering if they were only referring to the revision per lead.

I billed 63661 63661 51 it was denied and then I appealed trying to say it was per lead but I am relooking at the description at has the plural opition array(s). Should this code only be listed once for both one or two leads?

 

[rkmcoder]

(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

I looked and looked and found nothing definitive, which I am sure that you did also. I even looked at the 2010 CMS MUEs that would be a definitive source, but 63651 is not listed in the 2010 MUEs. So, looking at 63650, which states 'array', we know that that code is billed per lead. Unfortunately 63661 states 'array(s)' which means 'array or arrays'. Alas, we must then conclude that 63661 can be billed just once. Bummer.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

 

[dwaldman]

Thank you for your response. Back when 63660 was billed it also said array(s) but then there was that CPT Assistant article which states that 63660 can be billed per lead but they were only using the words implant not removal. So I looked at 63663 to see if this code said array(s) and it did. I read in the same article that when electrodes is plural in code 64555 because mulitiple electrodes are on one array. I was under the impression that when it is in the plural form that that meant one or multiple. I don't have CPT Changes for 2010 I would like to see if maybe this source addressed this.

 

[marvelh]

I paid for a written response from CPT KnowledgeBase on this very issue so I could have the correct information for my upcoming audio on spinal cord stimulators...the removal and revision/replacement codes are to be reported with a maximum of 1 unit of service regardless of the number of arrays / leads removed or revised / replaced. The information in the recent CPT Assistant issue illuded to this but was not "black & white" clear for some of my providers!

 

[dwaldman]

Thank you for the response. I saw that there is a April 28 audio conference that I going to sign up for on Monday. Since I know the costs of SCS procedures can be high for the carrier and sometimes the patient I want to know my coding is not adding unneccesary costs to already expensive procedure.