Wiki Interstim

[melwalters]

I am interested in finding out how to bill for the percutaneous placement of interstim (do I bill only 64561?) and what type of reimbursement you get from Medicare and commercial payers. We are located in Michigan.

Our patients would have this treatment for fecal incontinence, not urinary incontinence, but I understand the same process and equipment is used. If the patient does well with this trial we will not do the implantation.

 

[smh]

PNE codes

I am also in Michigan and bill Interstim for FI. I bill 64561 -50 (our surgeons place bilateral leads for the PNE) 95972 (programming of the temporary generator) and A4290 (PNE kit- which only Blue Care Network reimburses and for around $22.00.) Typically for a PNE (64561,95972) from Medicare we receive approx. $1093, BCBSM $2013, BCN Advantage $1258, Priority Health HMO/PPO $2292, Priority Medicare $1258 and Molina Medicare $1258. These are just a few. Also a question for you, I am having a hard time with Molina Medicaid and getting Interstim approved for fecal incontinence- do you have any experience with this? Thank you!

 

[melwalters]

Molina Medicaid and getting Interstim approved for fecal incontinence

Our physicians are only investigating at this point, we are not billing yet so I can't help with Molina Medicaid.

Thank you very much for the reimbursement info!