Neurology & Pain Management Coding Alert
Going Beyond the MUEs for 0282T
Question: Code 0282T has an MUE of 1 and code 64555 has an MUE of 2. According to the utilization guidelines of Noridian’s LCD L33714, “Trials will be limited to four leads with maximum of 16 contacts.” Does this mean we could bill up to four trial leads with either 0282T or 64555? Can we bill more than the accepted MUEs and receive payment?
Florida Subscriber
Answer:
The code descriptor for 0282T is “Percutaneous or open implantation of neurostimulator electrode array[s], subcutaneous [peripheral subcutaneous field stimulation], including imaging guidance, when performed, cervical, thoracic or lumbar; for trial, including removal at the conclusion of trial period).” The notation of “array(s)” means you bill the code with a maximum of one unit of service. Therefore, even with the payer’s limit of four leads (which is not unheard of with percutaneous field stimulation) the maximum number of units of service that you should bill for 0282T is one. The coverage policy does not discard the MUE limitation for either code 0282T or 64555 (Percutaneous implantation of neurostimulator electrode array; peripheral nerve [excludes sacral nerve]).
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