# Programming with SCS



## SCCL5558 (Sep 19, 2013)

We were told with Boston Scientific that we were not able to bill any of the programming codes 95971, 95972 or 95973 because their manufacturer representative did the programming after the provider did the SCS implant. Is this true??


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## dwaldman (Sep 19, 2013)

"From a CPT coding perspective, based on the information available in your inquiry, and in answer to your question, CPT is a set of codes, descriptions, and guidelines intended to describe procedures and services performed by physicians and other health care providers, therefore, it would not be appropriate to report this code if performed by a manufacturer's representative."
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Above is a part of response I received from the AMA CPT Network in regards to 95971/95972 from November 2010. 

Below is from the Medtronics PDF for Spinal Cord Stimulation 

http://professional.medtronic.com/pt...m-pm/index.htm


Analysis/ Programming
Note: In the office, analysis and programming may be furnished by a physician, practitioner
with an “incident to” benefit, or auxiliary personnel under the direct supervision of the
physician (or other practitioner), with or without support from a manufacturer's representative. The patient or payer should not be billed for services rendered
solely by the manufacturer's representative. Contact your local carrier or payer for interpretation of applicable policies.

Below is from the Boston Scientific PDF for Spinal Cord Stimulation

http://www.controlyourpain.com/profe.../physician.cfm


A physician should not bill if the service is performed entirely by, or under the direction of, a manufacturer representative without payer consent. If the service is performed in part by a physician or physician-supervised personnel (in accordance with the Medicare incident to requirements) and in part by a manufacturer representative, the physician should contact the payer and/or a reimbursement consultant before billing the service


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