Wiki Device intensive procedure, implant not implanted

[mhammy67]

We do spinal cord stimulators at our ASC. The surgeon attempted to implant one lead, could not manuver it into position, so they retacted that one, opend another and implanted the second one. Anyone who's facility implants SCS knows how expensive the leads are. The vendor charged the ASC for the lead even though the surgeon was not able to implant it.
1. Does anyone know the rules on device intensive procedure coding?
2. Would I code 63650 with a reduced service (???) modifer.
3. Can I even bill the code if the device was not implanted, but was attempted?

Payer is Medicare.

Thanks in advance

 

[capricew]

I am not an expert but I believe you would bill 63650 on line one for the completed procedure, and 63650-52 on the second line. Medicare will request records so they can see exactly what point the service was reduced at. Your documentation should be clear that the first lead was opened, attempted and then discarded so Medicare can reimburse you appropriately for the lead that was discarded. Every time I bill out a claim with the 52 modifier Medicare requests records from me so that they pay it according to what was completed in the procedure.

Good luck!