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Neurostimulators - CPT 64555 states implantation

  1. #1
    Question Neurostimulators - CPT 64555 states implantation
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    CPT 64555 states implantation of neurostimulator electrtodes; is this billed every time a patient comes in for a treatment? I've got a clinic that wants it billed every time the patient is seen, along with code 95970, electronic analysis of implanted neurostimulator. Has anyone billed this out before please?

  2. #2
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    You should not keep billing the 64555. This should only be billed once. We use code 95970, 95971,95974, 95975 mostly. You should be using the code under Neurostimulators Analysis- Programming.

  3. #3
    Default
    That's what I wanted to hear - thank you!!

  4. #4
    Default Reprogramming
    The company we use for the neurostimulator is telling our physician that when they come in to reprogram the device, he should be billing even if he doesn't see the patient. Our office schedules the appointment with the patient for the reprogramming, but we don't even see the patient. They are telling him that since we do the scheduling of the service, we can bill even if we don't see the patient. I don't feel comfortable billing for a service that I am not providing. Thoughts?

  5. #5
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    That is incorrect, and they should be ashamed of themselves. You cannot bill for a service that wasn't provided by an employee of your company, plain and simple.
    Walker Bachman, CPC, CPPM

  6. #6
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    Default
    Quote Originally Posted by dmaines40505 View Post
    The company we use for the neurostimulator is telling our physician that when they come in to reprogram the device, he should be billing even if he doesn't see the patient. Our office schedules the appointment with the patient for the reprogramming, but we don't even see the patient. They are telling him that since we do the scheduling of the service, we can bill even if we don't see the patient. I don't feel comfortable billing for a service that I am not providing. Thoughts?
    No, No, No...We were told that too...

    Auxiliary personnel means any individual who is acting under the supervision of a physician, regardless of whether the individual is an employee, leased employee, or independent contractor of the physician, or of the legal entity that employs or contracts with the physician. Likewise, the supervising physician may be an employee, leased employee or independent contractor of the legal entity billing and receiving payment for the services or supplies.

    However, the physician personally furnishing the services or supplies or supervising the auxiliary personnel furnishing the services or supplies must have a relationship with the legal entity billing and receiving payment for the services or supplies that satisfies the requirements for valid reassignment. As with the physician’s personal professional services, the patient’s financial liability for the incident to services or supplies is to the physician or other legal entity billing and receiving payment for the services or supplies. Therefore, the incident to services or supplies must represent an expense incurred by the physician or legal entity billing for the services or supplies.

    http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf

  7. Default NP's and neurostimulators
    We have a clinic that has the NP do the visit and the reprgramming of the stimulator....but when filing claim to OH Medicaid they deny this as prov/proc conflict.....any magic modifier out there:

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