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Thread: Billing for Trial Spinal Cord Stimulator Leads

  1. #1

    Default Billing for Trial Spinal Cord Stimulator Leads

    AAPC: Back to School
    A patient came in for a trial spinal cord stimulator placement. Two leads were to be placed. The first lead was placed on the left side of T-8. The second lead was to go on the right side of T-8 but after multiple attempts (x5) the lead was in the anterior epidural space. There were no other interspaces available for the lead because all other interspaces were fused and the lead was finally abandoned. Only one lead was placed.

    I asked the physician and he said he was unable to place the 2nd lead and removed it. The leads were purchased by the practice.

    Will we be able to be reimbursed for the device even though it wasn't implanted? How should this be billed?

    How should this be billed for the physician? I know I can bill for placement of the one lead but what do I do about the other lead as far as the physician bill? Bill it as if it were placed? Bill it with a modifier for reduced services?

    This has never happened before so I'm not sure what is the correct way to do this.

    Thanks for any help you can give.

  2. #2

    Default Trial SCS lead that was not placed

    I am answering my own post as I was finally able to talk to someone that knows how to bill for SCS leads and placement.

    The second lead placement should be billed with 63650.53 because the doctor attempted to place the lead but had to discontinue the procedure due to extenuating circumstances. It required more work in the numerous attempts versus billing with a 52 modifier for reduced services.

    The inability to place the second lead was an unforseen event. The practice purchased the lead and should be reimbursed. As long as documentation supports the attempted placement the lead can be billed.

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