Results 1 to 7 of 7

Removal Stimulator Generator/receiver

  1. #1
    Default Removal Stimulator Generator/receiver
    Medical Coding Books
    We did a removal and replacement of a pulse generator on a stimulator that was implanted several years ago by a different physician.

    Is it just 63685, or 63688 and 63685?

    I think 63685, but doc thinks both can be billed.

  2. #2
    63688 (removal) is a component of 63685 (replacement) if at same location. 63688 is not separately billable per NCCI edits.

    Julie, CPC
    Last edited by jdrueppel; 05-13-2009 at 07:50 PM. Reason: typo

  3. #3
    North Carolina
    Per CPT Assistant~

    "This instruction refers to the circumstance where a pulse generator is removed and the same generator is reinserted. For example, the pulse generator is removed due to disconnection of the lead(s), the lead(s) are reconnected, and the same generator is reinserted. Another example is in the event the generator is resting on the pelvic rim and is moved due to pain. In these two specific circumstances, the work is considered revision of an existing generator so only code 63688, Revision or removal of implanted spinal neurostimulator pulse generator or receiver, should be reported. It would not be appropriate to report code 63688 for removal of the generator in addition to code 63685, Insertion or replacement of spinal neurostimulator pulse generatoror receiver, direct or inductive coupling, to describe reinsertion of the same generator. To further clarify, code 63688 may also be reported independently, for example, in the event of infection or because a satisfactory response to treatment has not been achieved. In this circumstance, for removal of the lead array, code 63660, Revision or removal of spinal neurostimulator electrode percutaneous array(s) or plate/paddle(s),should also be reported."
    Last edited by RebeccaWoodward*; 05-11-2009 at 02:48 PM.
    Rebecca CPC, CPMA, CEMC

    Your click COUNTS...

    CLICK to give FREE mammograms!

  4. #4
    I've read that CPT Assistant excerpt but even taking into account the CPT parenthetical "Do not report 63685 in conjunction with 63688 for the same pulse generator or receiver" I'm not sure how to get around the NCCI edits as 63688 is bundled into 68685 and no modifier is allowed for
    over-ride. I was at the University of Chicago Anesthesia meeting in Las Vegas in March and there was plenty of discussion regarding these codes. The final advise from Joanne Mehmert, the ultimate pain coding guru in my opinion, was to get written clarification from each payer and bill accordingly.

    Julie, CPC

  5. #5
    North Carolina
    I agree with you Julie. Unfortunatley, carriers create needless hurdles for these particular procedures. We can be at the mercy of their policies.
    Rebecca CPC, CPMA, CEMC

    Your click COUNTS...

    CLICK to give FREE mammograms!

  6. Default Spinal stimulator removal generator/receiver
    Can we bill 63688 and 63685 together?

    Rebecca Woodward cited a CPT assistant and quoted it. I need to find that CPT assistant to print it for proof. Is Rebecca "listening" or does anyone know what issue of CPT assistant that I can find this article.

    Thank you!!!

  7. #7
    15. CPT codes 61885, 61886, and 63685 describe “insertion or replacement” of cranial or spinal neurostimulator pulse generators or receivers. CPT codes 61888 and 63688 describe “revision or removal” of cranial or spinal neurostimulator pulse generators or receivers. If the same pulse generator is removed and replaced into the same or another skin pocket, the “replacement” CPT code may be reported. The “removal” CPT code is not separately reportable. Similarly, if one pulse generator is removed and replaced with a different pulse generator into the same or another skin pocket, the “replacement” CPT code may be reported. The “removal” CPT code is not separately reportable. The “insertion or replacement” CPT code is separately reportable with a “revision or removal” CPT code only if two separate batteries/generators are changed. [B][U]For example, if one battery/generator is replaced (e.g., right side) and another is removed (e.g., left side), CPT codes for the “insertion or replacement” and “revision or removal” could be reported together with modifier 59

    Above is from the NCCI policy manual, I didn't see the coding scenario described in April 2011 SCS article with multiple Q and As

Similar Threads

  1. Vagal Nerve Stimulator- replacement of pulse generator
    By ksb0211 in forum General Surgery
    Replies: 1
    Last Post: 01-20-2012, 01:41 PM
  2. Replies: 3
    Last Post: 02-15-2011, 03:59 PM
  3. Removal of Bone stimulator
    By chaveje in forum Orthopaedics
    Replies: 0
    Last Post: 03-11-2010, 03:33 PM
  4. ANS occipital stimulator pulse generator
    By Jamie Dezenzo in forum Outpatient Facilities
    Replies: 2
    Last Post: 09-18-2009, 01:27 PM
  5. Removal of InterStim leads and generator
    By scgcpc2002 in forum Outpatient Facilities
    Replies: 1
    Last Post: 10-01-2008, 02:08 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.