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Neurostimulator Trial lead removal

  1. Question Neurostimulator Trial lead removal
    Medical Coding Books
    Does anyone bill for removal of neurostimulator leads for trial? We usually place leads 63650 for 5 day trial and remove. Currently, we do not charge for removal because it is done within global period.
    Dr's colleague said they always bill 63660+58 since removal was plannned procedure and within the global period. Does it matter if trial was failed and therefore no permanent placement of leads/pulse generator will be implanted?
    Global period changed from 90 days to 10 days as of 1/1/09, but scope remains the same.
    Are we missing out on opportunity to bill or is this service inclusive?

  2. #2
    Albany, New York
    Are "permanent" leads being placed at the time the "trials" are being removed?
    Karen Maloney, CPC
    Data Quality Specialist

  3. Default
    No - leads are always temporary placement and removed. If the trials is a success, they schedule permanent placement 4-6 weeks later (after healing) and we again bill 63650+58. If unsuccessful, we just remove the leads during a postop visit.

  4. #4
    Albany, New York

    The surgeons that perform this type of procedure at the facility where I work replace the trail lead with permanent lead(s) at the same operative session (if the trial was a success), for which I only code 63650.

    I think you would be okay coding 63660 subsequent to the placement if the leads were removed and not replaced.
    Karen Maloney, CPC
    Data Quality Specialist

  5. Default
    Thanks for the imput ... I am unsure of implementing this billing "opportunity" but I don't to be under billing our services either.

    I am more confident of billing for lead removal for failed trials versus prior to permanent implantation occurring well after the 10 day global period.

    I appreciate the help.

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