Wiki Removal of Two Nerve Stimulators before InterStim Placement?

[toria11]

"Patient has a long history of overactive bladder. In 2005 a patient had a pudendal stimulator placed which did not work and is still in place. The patient also had an InsterSim stimulator that was placed several years later but it has stopped working because the battery is dead and she has not had it looked at for years. She presents now for removal of the pudendal nerve stimulator unit as well as removal of the InterStim stimulator and lead. Also presents for placement of new sacral nerve stimulator and lead."

I know when coding for the placement or replacement of an Interstim, removal of the old system is not separately reportable and you would code 64581, 64590, 76000-26. Would this still be the case even though the physician is removing TWO stimulators before placing her new one?

Thank you!

 

[liqgold2@aol.com]

If the removal of the second generator prolonged the operation time at least 25% longer than normal, add modifier-22 to the 64590 and give a good explanation of this fact in your operative dictation and increase the fee 25% more.