# Attempted trial spinal cord stimulator



## larkatin (May 14, 2009)

Dr. attempted to place a trial spinal cord stimulator.  Portion of his note reads:

"With the aid of fluoroscopy the T12, L1 interspace was identified.  Local anesthesia was infiltrated consisting of a total of 20 cc of 0.5% Bipuvicaine.  Using a posterior lateral approach a 16 gauge, 4 1/2 inch Tuohy epidural needle was inserted down to the posterior lamina of the posterior aspect of the L1 lamina and walked off the superior aspect of the lamina.  Entry into the L1, L2 epidural space was not possible due to the severe degenerative arthritis, as well as severe scoliosis.  There was no interlaminar opening to access the epidural space.   After multiple attempts at the T12, L1, L2 levels, as well as the L2-3 levels, the procedure was aborted."

How do I bill for this?

63650-53?
77003-26?

American Progressive, Today's Options, has denied as invalid procedure/modifier submitted.

THANKS!


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## jdrueppel (May 14, 2009)

You don't mention the place of service.  Could it possibly be that the payer is looking for the -73 or -74 modifier on the spinal cord stimulator code due to the place of service?

Julie, CPC


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## larkatin (May 20, 2009)

It was done as an oupatient in the hospital - POS 22.


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