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Billing Question in regards to Percutaneous Stimulator

  1. #1
    Nashville Tennessee Chapter
    Default Billing Question in regards to Percutaneous Stimulator
    Medical Coding Books
    I have a question in regards to the billing for a Percutaneous Stimulator (for a trial). We are interested in starting them for our office, but are being advised by a Drug rep to bill out what seems to be way to high and too good to be true reimbursement. Our office plans to bill out for the leads that go with the percutaneous stimulator as well.

    This is what we are being told to bill:
    64555- Percutaneous implantation 1 unit to bill.
    L8680- Implantable neurostimulator electrode each. 16 units to bill (since billed per lead).

    The description of procedure for us is: Placement of peripheral nerve stimulator lead times two. (which would equal the 16 leads since each lead has 8).

    I had been advised at one point to bill out the 63650 instead of the 64555 and not bill out for the leads (L8680), but I am not sure that this is correct either.

    Reimbursement on this seems very be high since we are doing this in our office and almost seems to good to be true. I want to make sure before we accept and start billing for a lot of these, that we do not get into trouble for the codes being billed. Drug reps tend to make the deal sound better than what it truly is for business so I'm a bit skeptical.

    I hope that you will be able to have better insight on this than I do. Your time and help in this matter is greatly appreciated.


  2. #2
    Default Here is what we do
    64555 is for leads for peripheral nerve stimulation, 63650 is for leads for spinal cord stimulation. Make sure which you are doing. Then, code per lead. So if you implanting two leads, code two leads.

    As far as L8680, why would it be 16 units? You have purchased two leads (arrays), so bill two leads.

    Again, this is what we do, others may do it differently.

    Caution (and you know this): Pay little attention to what reps say. You get audited, not them. I had one rep tell me that a TENS unit fitting was a level 4 office visit!

    Richard Mann, your pain management coder

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