# post op SCS trial with 95970



## jeannie1977 (Feb 5, 2015)

I do charge entry for a pain management doctor.  He is seeing patient's as follow up to SCS trial.  He is performing 95970 (electronic analysis) at this follow up.  He is wanting to charge 99213 and 95970.  I know the 63650 has a 10 day global, so I can not bill 99213.  Can I still bill the 95970?  Thank you for your help.


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## dwaldman (Feb 6, 2015)

95970  Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple or complex brain, spinal cord, or peripheral (ie, cranial nerve, peripheral nerve, sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, without reprogramming  

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I think the first step is make the physician aware that CPT 63650 currently has a 10 day global period and the encounter for the trial lead removal is considered within the global period. When reviewing CPT 95970 since it is diagnostic it would allow payment in the global period. But documentation of the reason for analysis of the temporary system would have be straight forward. SCS procedures  trial and permanent mplantation can cost between 5,000 to 26,000 in a hospital setting. And there can be a high rate of removal within 2 years. Due to the costly nature of the devices. I believe a full understanding of why CPT 95970 is being billed during the removal would need to clear in the documentation. 

 The code descriptor describes analysis of an implanted system. Although the AMA describes in CPT Assistant
permanent or temporary, it seems the code descriptor of implanted system would be a more realistic use of these codes if the service is being solely performed by the physician not the manufacturer's representative.

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AMA 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 a temporary 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 the lead placement, 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 the leads (not the pulse generator)......


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