Neurosurgery Coding Alert

Question: The surgeon 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. Should I report 61885 or 64555 for this scenario?

Texas 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 incorrect nerve type.

Also note: If the trial is successful, 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.