Billing for Spinal Cord Stimulation Trial or Permanent
Feb13

Billing for Spinal Cord Stimulation Trial or Permanent

Billing for Spinal Cord Stimulation Trial or Permanent Spinal Cord Stimulation is indicated in patients who have chronic moderate to severe pain of the trunk or limbs who have failed more from the conservative treatment. According to Laxmaiah Manchikanti, MD’s book, there are some specific criteria that a patient should meet including: 1. More conservative options have failed or are not acceptable to the patient 2. The patient should have a definable pathology to explain the current pain complaints 3. The patient should have no untreated drug addiction 4. The patient should have no unstable depression or anxiety disorders. The presence of these problems are not a contraindication, but, if present treatment should be initiated prior to implanting a permanent system 5. No contraindications should exist such as systematic infection, uncontrolled bleeding disorders, local infection at the implant site, or severely uncontrolled diabetes mellitus. 6. A trial of stimulation should be attempted prior to the permanent implant, and should give acceptable outcomes for pain relief (50% or more) and functional improvement. 7. The patient should understand the risk and expectations including nerve injury, epidural hematoma, epidural abscess, infection, paralysis, death, mechanical failure, failure to produce pain relief and risks of anesthesia As of April 2014, HCPCS code L8680 became a non-payable code since it is bundled wih the Neurostimulator Device. The electrodes is now being bundled with the 63650 For neurostimulator devices, HCPCS code L8680 is no longer separately billable for Medicare because payment for electrodes has been incorporated in CPT code 63650 (Percutaneous implantation of neurostimulator electrode array, epidural). Providers should not not report electrode(s) using code L8680 in conjunction with a lead implantation procedure provided in any setting for Medicare. CPT Procedure Code Utilized on Billing for Spinal Cord Stimulation Trial or Permanent 63650 Percutaneous implantation of neurostimulator electrode array, epidural 63655 Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural 63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed 63662 Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed 63663 Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed 63664 Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed 63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling 63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver Device HCPCS Codes used When Billing for Spinal Stimulation Trial or Permanent L8679 Implantable neurostimulatorpulse generator, any type L8680 Implantable neurostimulator electrode (with any number of contact points), each L8682 Implantable neurostimulator pulse generator, Dual array,...

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