Orthopedic Coding Alert

Question: The patient had spinal surgery in the past and then had a stimulator implanted percutaneously by a physician from a pain management practice. The patient now needs another spine surgery and the surgeon is removing the neurostimulator. Can the surgeon charge for removal of the neurostimulator? Can we bill 63650 with 63661?

Georgia Subscriber

Answer: You report 63661 (Removal of spinal neurostimulator electrode percutaneous array[s], including fluoroscopy, when performed) for the removal of arrays and 63688 (Revision or removal of implanted spinal neurostimulator pulse generator or receiver) for the removal of the generator.

Code 63661 cannot be billed with code 63650 (Percutaneous implantation of neurostimulator electrode array, epidural). Here removal is a separate date of service and the mutually exclusive edit with 63650 would not be applicable. If the removal is followed by replacement with another set of electrodes, you report 63663 (Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array[s], including fluoroscopy, when performed).