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I know that 95972 is used for programming of implanted spinal systems, but my physician wants to know if there is a code for programming the leads of a trial system. I could not find anything. Does anyone know if a code exists?
I would review with the physician who is performing the programming. Typically the hand held device that is used to do the programming is owned by the manufacturer. The manufacturer's representative brings this device when they bring the leads that are being placed then the manufacturer's rep who is familiar with how the device works and how to perform the programming is the actually person is preforming the programming not the physician. Maybe you are encountering a situation where the physician is personally performing this using the manufacturer's equipment, but if the physician is not personally performing it then is not separately reportable.
In AMA CPT Assistant April 2011, they state that if only impedance testing is performed then reprogramming codes would not be separately reported. They describe using the 9597X codes with an external unit even though the code descriptor specifically states "implanted." I sent a question the AMA CPT Network to confirm that the programming of external unit is still able to be reported with 9597X and they cited the below CPT Assistant and stated yes. In the past I had heard from a rep from Medtronics that their consultants with NASS stated they believe it was inherent during the trial placement, which I personally agree with. But from AMA standpoint, it appears they allow these codes reported for programming during temporary placement as long it is not impedance testing only.
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APRIL 2011 AMA CPT ASSISTANT
Question 3: May code 95972 be reported for complex programming of an external nonimplanted neurostimulator pulse generator that is attached to a temporary electrode array?
AMA Response: Correct choice of programming codes is not based upon the intent of the stimulator lead array being used as a "temporary" external lead or as a "permanent" implanted lead. An inherent portion of the lead placement, and is not additionally reported using either code 95971 or 95972, is electronic analysis during a percutaneous electrode array placement (63650) or during a laminectomy for implantation of a plate/paddle electrode array (63655) when only impedance testing and stimulation is performed to verify function of the leads (not the pulse generator).