Neurology & Pain Management Coding Alert

Reader Question:

I.D. Nerve Before Coding Occipital Stimulation

Question: Our pain management specialist placed a dual 8-electrode occipital stimulator subcutaneously for trial occipital stimulation. Fluoroscopy confirmed the appropriate lead location. The same technique was repeated on the right side. I can’t decide whether code 61885 or 64555 would be more accurate. What’s your advice?

Rhode Island Subscriber

Answer: The better option is 64555 (Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)). Code 61885 (Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array) is not as appropriate because it represents the wrong nerve.

Also note: If the trial is a success, you’ll submit 64590 (Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling) if a neurostimulator pulse generator is placed later.