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Spinal Cord Stimulator percutaneous subcutaneous imiplant x 2

  1. #1
    Default Spinal Cord Stimulator percutaneous subcutaneous imiplant x 2
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    How would this be coded?
    Procedure: Pelvic Spinal Cord Stimulator percutaneous subcutaneous imiplant x 2 with battery implant and programming fluoroscopic guided
    Risks and benefits reviewed. Informed consent signed Pause for cause performed. Pt. was escorted back to the procedure suite and placed in the supine position. After a sterile prep and drape I anesthetized the skin with 1% lidocaine. I used a 14 gauge touhy needle to advance to the subcutaneous percutaneous location in the pelvic/labral region. A second lead was placed using the same technique with one on the right side and one on the left side. I placed the second lead next to the first lead and again programmed the lead for adequate stimulation. There was no significant Heme, or parasthesia during the procedure.
    Once lead placement was confirmed by fluoroscopy I made a 4 cm in length incision and dissected to the fascia plane. I secured the leads in place to the fascia with anchors and 2-0 silk sutures. Then I went to the left abdominal region and made a 4-5 cm incision and dissected out a pocket for the battery. I then tunneled the SCS leads under the skin to the battery location. I connected and verified connectivity with the equipment representative. I irrigated the wounds and then closed the deeper layers with 2-0 vicryl and then used staples for the skin.
    Primpore dressing applied to the wounds and the patient was carefully transferred the the recovery room.
    There was no complication during the procedure and further programming was performed in the recovery area.

  2. #2
    Any suggestions would be helpful. My Dr wants the unlisted codes.

  3. #3
    Denver Colorado
    Consider 64555 Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) x 2 and 64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling

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