Neurosurgery Coding Alert

Question: Our physician did a repositioning of spinal cord stimulator (SCS) in a patient who had laminectomy for placement of SCS a couple of months ago. The pain complained of pain in the site of the SCS generator. Our physician externalized the generator and reinserted the generator in deeper pocket. How can we report this procedure?

Ohio Subscriber

Answer: You should report code 63685 (Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling) for the revision of the spinal cord stimulator. The code 63685 applies to insertion as well as replacement of the spinal cord stimulators. You may append modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period) only if the replacement or revision occurs in the global period of the initial procedure.