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Cpt 95972 with 63650 ???

  1. #1
    Talking Cpt 95972 with 63650 ???
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    Can you report the adjustment of a spinal cord stimulator, during the implant of the trial and/ or permanent placement of the unit?

  2. #2
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    My understanding is that 95972 is not separately reportable with a temporary array placement, AKA, SCS Trial Below is from CPT Assistant April 2011


    Question 3:May code 95972 be reported for complex programming of an external nonimplanted neurostimulator pulse generator that is attached to atemporary-electrode array?

    AMA Response:Correct choice of programming codes is not based upon the intent of the stimulator lead array being used as a“temporary”external lead or as a“-permanent”implanted lead.An inherent portion of theleadplacement, and is not additionally reported using either code 95971 or 95972, is electronic analysis during a percutaneous electrode array placement (63650) or during a laminectomy for implantation of a plate/paddle electrode array (63655) when only impedance testing and stimulation is performed to verify function of theleads(not the pulse generator).

    Codes 63650-63688 apply to both simple and complex neurostimulators. Therefore, codes 95970-95975 are reported for initial or subsequent electronic analysis and programming ofneurostimulator pulse generators. The guidance to determine electronic analysis of an implantedsimpleversuscomplexneurostimulator as specified in the CPT guidelines is based upon device capability, as reflected in either neurostimulator programming code 95971,Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple spinal cord, or peripheral (ie, peripheral nerve, autonomic nerve, neuromuscular) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming,orcode 95972, Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, first hour.

    As stated in the CPT guidelines,code 95971 describes intraoperative or subsequent electronic analysis of an implanted simple spinal cord or peripheral (ie, peripheral nerve, autonomic nerve, neuromuscular) neurostimulator pulse generator system with programming. Codes 95972 and 95973 describe intraoperative (at initial insertion/revision) or subsequent electronic analysis of an implanted complex spinal cord or peripheral (except cranial nerve) neurostimulator pulse generator system, with programming.

    A simple neurostimulator pulse generator/transmitter (codes95970, 95971) is one capable of affecting three or fewer of the following: pulse amplitude, pulse duration, pulse frequency, eight or more electrode contacts, cycling, stimulation train duration, train spacing, number of programs, number of channels, alternating electrode polarities, dose time (stimulation parameters changing in time periods of minutes including dose lockout times), more than one clinical feature (eg, rigidity, dyskinesia, tremor). A complex neurostimulator pulse generator/transmitter (codes95970, 95972-95975) is one capable of affecting more than three of the above. Modifier 52,Reduced Services, should be appended to code 95972 in the event the duration of the services was performed in less than 31 minutes.

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