Neurology & Pain Management Coding Alert
Be Clear on Electrode Array Counts
Question: Our physician’s operative report reads “bilateral 4-lead subcutaneous field stimulators with battery insertion ......” We billed 64555 (Percutaneous implantation of neurostimulator electrode array; peripheral nerve [excludes sacral nerve]) x4. Medicare denied payment stating that number of units exceeded acceptable maximum. Can you please explain how we can bill this again?
Colorado Subscriber
Answer: The key to your question is the term “subcutaneous field” stimulators. Report the procedure with 0283T (Percutaneous or open implantation of neurostimulator electrode array[s], subcutaneous [peripheral subcutaneous field stimulation], including imaging guidance, when performed, cervical, thoracic or lumbar; permanent, with implantation of a pulse generator). You should report a maximum of one unit of service for 0283T as it includes implantation of all arrays (leads) as well as implantation of the pulse generator.
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