Eli's Rehab Report

You Be the Coder:

Disposable Stim Pads

Published on Thu Feb 01, 2001

Question: If we use one-time disposable stim pads in the office, would this be billed to insurers as a supply or are they part of the overall procedure?

Arizona Subscriber

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Answer: Disposable stim pads are used to attach wires for TENS (transcutaneous electrical nerve stimulators [64550] or electrical muscle stimulation [97032] machines), which often are used to treat osteoarthritis (715.0-715.9), muscle atrophy (ICD-9 728.2 ) and other conditions. Coding guidelines dictate that you shouldnt bill for an item such as disposable stim pads unless they are above and beyond what normally would be used to deliver that service or treatment. In the case of electrical stimulation, the stim pads would be included in the procedure.

There is a HCPCS code for TENS supplies (A4595, TENS supplies, two lead, per month), but it is restricted for durable medical equipment (DME) supplier use another indication that providers are not expected to bill for these separately. DME suppliers have access to the code to report issuing home-use devices such as a personal TENS unit. Of course, this would require that the patients physician ordered the TENS unit and also signed a certificate of medical necessity if indicated. (For more on DME billing, see the cover article Medical Necessity Is Key to Reimbursement for DME Supplies.)

Note: Advice for You Be the Coder was provided by Laureen Jandroep, OTR, CPC, CCS-P, owner of A+ Medical Management and Education, a coding and reimbursement consulting firm and a national CPC training curriculum site in Egg Harbor City, N.J.