Temp. Interstim placement, cpt 64561

vmnickerson

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I need help coding temporary placement of neurostimulator leads. The rep says to use 64561, 64561-59. Is this correct, or should I use the -51 modifier. Also, I have had denials when I filed a 99213 e/m visit to remove the temps, as the person had decided to have them placed permanently. Please help! Any input would be greatly appreciated. My office is new to coding and billing for the procedure and we have had confusing results.
 

vmnickerson

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cpt 64561 I can really use some HELP!!!

:) IF there is anyone outthere working in a urology specialty office. These codes are driving my crazy, because the manager, that generates the claim. is not sure on billing, and I'm the one that gets to fix the problem when they are denied. If anyone can give me an idea on this. We are running two leads to determine where the placement ofthe permanent one will be. Should be use modifier 59, or 51. Thanks for reading my posts, and I hope to hear from someone soon./v
 

jlawson

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64561 with -RT, -LT and -59 modifiers

I need help with this code, too. I was told to use the -RT and -LT modifiers since both sides were done and to add the -59 to one of those. Thanks for everyone's help with this.

Joy
 

Denises

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64561

Here are some resources to help you out on urology coding:

1. The AUA website has a lengthy Coding and Reimbursement section of Q & A's and you do not need a username/password. Check out www.auanet.org. It is awesome!

2. The Coding Institute has a "Urology Coding Alert" newsletter that is also fantastic. After you subscribe to the newsletter you can search all the Urology newsletters published for coding information. There have been a couple on 64561. Check out www.codinginstitute.com

3. DecisionCoder website, soon to be changed over to CustomCoder, is another terrific coding resource with their "Coach" Q & A section. Check out www.DecisionCoder.com and get a trial subscription.

4. Medtronic, the manufacturer of the Interstim leads/electrodes, has a reimbursement section on their website as well. Check out www.medtronic.com (I'm working from memory here, I think that is the website address, if not, google it).

Can you tell I've been down your road before on this topic!!

5. I have found that the insurance carriers differ on this topic. I feel that 64561 should be reported once because the narrative description states "electrodes"--plural, but the surgeon insists we bill each unit. So, we report 64561-RT and 64561-59, LT (mod 59 to show a separate site/location). Some pay, some will not pay the units.

Hope this helps. Good Luck.
Denise Stanton, CPC, CCP-P
 
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