Anesthesia Coding Alert

Question: How many specific codes make up the entire spinal cord stimulator process?


Minnesota Subscriber

Answer: Most pain centers begin with a trial stimulator implant (63650, Percutaneous implantation of neurostimulator electrode array, epidural). This has a 90-day global period. If it works for the patient, he returns for the stimulator implant (usually within the 90-day global period), and the physician removes the trial implants (63660, Revision or removal of spinal neurostimulator electrode percutaneous array[s] or plate/paddle[s]); append modifier -58 (Staged or related procedure or service by the same physician during the postoperative period).

Then the physician implants new neurostimulator electrodes (63650-58) and places the pulse generator (63685, Incision or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling).

The final procedure step involves analysis of the stimulator once everything is in place. If the physician conducts analysis, report 95970 (Electronic analysis of implanted neurostimulator pulse generator system [e.g., rate, pulse amplitude and 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 [i.e., cranial nerve, peripheral nerve, autonomic nerve, neuromuscular] neurostimulator pulse generator/transmitter, without reprogramming) or 95971 (... simple spinal cord, or peripheral [i.e., peripheral nerve, autonomic nerve, neuromuscular] neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming).