Wiki Spinal Cord Stimulator Electrodes Implant - Anthem denial

[lcole7465]

I have been recently been receiving denials from Anthem denials on the SCS Electrodes implants. We bill CPT 63650 x2 (the doctor is placing 2 leads). We get an authorization for 2 leads and they keep denying the 2nd lead. As far as I've seen, the coding hasn't changed as this shouldn't require a modifier for the 2nd lead.

Thank you

 

[dwaldman]

AMA CPT Assistant April 2011
"For percutaneously placed neurostimulator systems (63650, 63661, 63663), the contacts are on a catheter like lead. An array defines the collection of contacts that are on one catheter."

 

[dwaldman]

If they are doing two leads, you are billing two units of 63650. How do you know they are denying the second lead? Are you not using two units? An array is synonymous with a lead. CPT 63650 is reported per Lead(Array) placed. CPT codes like 63661 63663 are plural and only one unit is specifically instructed with those codes, but @LisaAlonso23 I am not following 63650 can only be reported once.

 

[mbhgrace1]

Is the removal of a PNS (64585) included in the placement of one (64555)?

 

[tammyboyer]

for two leads i code as:
63650 (1) unit and then on line two i code 63650-76

 

[dees0131]

63650, 63650(59)

 

[cgaston]

The AANS suggests billing 63650, 63650-59 if a second electrode is placed