Urology Coding Alert

In the January issue of Urology Coding Alert Extra (Calm Your SNS Coding Nerves), it states "code the first temporary lead with 64561 and each additional temporary lead with 64561-50, each on a separate line." This statement should read "code the first temporary lead with 64561 and each additional temporary lead with 64561-51, each on a separate line." Although it is indicated in the Medicare Physician Fee Schedule Database that 64561 should not be billed using modifier -50, some private and commercial payers may want you to use modifier -50 on the second line when billing bilateral leads, regardless of Medicare's requirement that you use modifier -51. Be sure to check with your carrier before deciding how you should code 64561 performed bilaterally.

Also, under the subheading "Don't Complicate Lead, Generator Removal Coding" it states, "Two months after the implantation of the generator, the patient presents with severe infection from one of the implanted permanent devices. As in the previous example, use 64585 for the removal of the permanent lead and 64595 for the removal of the permanent generator." For Medicare carriers, you will need to append modifier -78 to 64585 to indicate a return to the operating room for a related procedure during the postoperative period. Modifier -78 may or may not be required when billing non-Medicare carriers, because global periods for the initial procedure will vary.