Wiki spinal cord stimulator

[JYSPA]

neurosurgeon did :
a. remove spinal cord stimulator battery
b. remove epidural spinal cord stimulator paddle including leads
c. placement new spinal cord stimulator epidural paddle
d. placement new battery including connector leads
e. interrogation of device

He is billing 63664,63685,63662,63688,95972,63655.

I am thinking that 63664 includes 63662, 63655. And 63685 includes 63688. Also 95972 is not billed when replacing generator.
This makes me have only 63664,63685.. I am not sure, therefore any advice welcome..

 

[SharonCollachi]

I agree with you. Also check with the manufacturer, they should have cheat sheets and information available.

You are correct, programming codes are not used when implanting, and are also not used when an employee of the manufacturer is doing the programming.

Generator replacement (battery): 63685
Replacement of one paddle: 63664

When an existing generator is removed and replaced by a new generator, only the generator replacement code 63685 may be assigned. NCCI edits do not allow removal of the existing generator to be coded separately. Also note that, according to NCCI policy, use of the CPT code for generator “insertion or replacement” requires placement of a new generator. When the same generator is removed and then re-inserted, the “revision” code is used (NCCI Policy Manual 1/1/2020, Chapter VIII, C.16.).

The AMA has published that replacement codes 63663 and 63664 are assigned when a permanent lead is replaced by another permanent lead of the same type via the same approach at the same spinal level. The work of removing the existing permanent lead is included and is not coded separately (CPT Assistant, August 2010, p.8,15; April 2011, p.10- 11,15). In addition, NCCI edits do not permit removal codes 63661 and 63662 to be assigned separately with replacement codes 63663 and 63664.

 

[sarab86]

I agree definitely 63664 and 63685. Checking the the integrity of the system is included.