Wiki Bundling issue!!!

[Orthocoder269]

Hello,

I'm coding a procedure where our physician will do a removal of an implanted spinal cord stimulator device and well as perform a lumber transforaminal epidural.

I have coded it:

63662
63688-51
64483-51-76 (76 for Medicare)
64484

The CCI states that 64483 bundles with 63688 and no modifier is allowed, it also doesn't like the 64484 as an additional injected level. I can't tell if this means he cannot perform the removal of the stimulator and the epidural on the same date of service??

 

[OCD_coder]

I am curious, is the injection for a separate problem or are they to for the purpose (analgesia/anesthesia) for the removal of the stimulator? Otherwise, you are correct you only bill the neurostimulator and lead removal as they would be the primary purpose for the surgery. You cannot bill for both, period.

I have only heard that Medicare requires a modifier 76, you may have meant a modifier 79. Not sure where this information originated, we have no issues getting paid, we limit it's use only if a repeat procedure is performed on the same DOS for the same anatomical site, identical procedure. Rare.

Could be a carrier thing I suppose.

 

[syed111]

I am obliged to answer this. Since the reason for operation is removal of implanted stimulator, so u can just go ahead and code only 63688 because the giving epidural anesthesia is an integral part of that procedure. Thanks.