# Inter-Stim Therapy with placement of tined leads



## NESmith (Apr 4, 2014)

Please help coding this procedure....
Anesthesia: local with sedation for tined lead placement and general with propofol for pocket creation.

Description of Procedure:
With the patient in the prone position under satisfactory sedation with versed and fentanyl the lower back and buttocks are all prepped and draped in the usual sterile fashion. With fluoroscopic control the site for injection and then tined lead placement is determined nased on bony pelvic landmarks and after placement of guide, testing is done and the patient exhibits appropriate reflexes and sensation to indicate that we are in the S3 neuroforamen optimum for implantation today. With the introducer the tines lead is placed and guidewires and introduucer are then removed and cross-table lateral and anterior posterior view of the fluoroscopy shows excellent positioning of her tined lead. It is tested and reflexes and sensation are as desired.
The electrode and connector is coverd with a boot after connecting the external lead after tunneling beneath the skin and subcutaneous fascia on the left buttock to the planned pocket which will ultimately receive the generator if this is converted to a permanent implant. From this pocket after placing the boot and contained contact the external extension is brought out through a separate stab incision above the level of the transverse pocket. Incisions are closed with interrupted 2-0 nylons. Dressing is applied. patient transferred to recovery in stable condition.
Please after review would the correct CPT code be; 64651 or 64581 based on the pocket being created.
Thank You for your help in this matter.


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## NESmith (Apr 18, 2014)

Please anyone???


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## vanessa01 (Apr 18, 2014)

I vote for 64581 and 76000 for the fluoro 
Vanessa


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## nateich (Apr 23, 2014)

I agree with Vanessa. Add -26 to 76000 unless physician owns equipment.


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