Neurology & Pain Management Coding Alert

Question: The neurologist documented, "Trial of neuromodulation with spinal cord stimulation using two spinal cord stimulator leads (each with eight electrodes)." I don't know much about neuromodulation. How do we code the procedure?

Answer: Your best choice is 63650 (Percutaneous implantation of neurostimulator electrode array, epidural). If your physician implanted the trial epidural arrays in the office site of service, then you may also include L8680 (Implantable neurostimulator electrode, each) for the actual implants. Coding for the epidural implant is based on the total number of electrodes/contacts, not the number of leads like the CPT code rules. In this scenario, report 16 units of L8680 for the 16 electrodes on the twoepidural arrays/leads.

Terminology check: Don't let "neuromodulation" confuse your coding. The term, also known as neurostimulation, is defined as electrical stimulation of a peripheral nerve, the spinal cord, or the brain for pain relief. That makes 63650 appropriate for the placement of the trial epidural leads.