february 2017

Know Your Neurostimulators

Neurostimulators have evolved to the point where there are many different types of devices on the market and it is necessary for the coder to understand how these devices operate and what components are involved to ensure proper billing.

  • The first neurostimulator we will review has two types of components – the electrode(s) and pulse generator. This used to be the most common type of neurostimulator implantation where the electrode(s) were placed percutaneously or by way of a laminectomy and then the leads were tunneled to a separate site where a pocket was made and the lead(s) would be attached to a pulse generator with the generator then being placed in the pocket.
  • Nevro Sensa HF-10 – This device uses a “high frequency” generator. Components and implantation are the same as described above. A non-high frequency generator produces a buzzing sensation (known as paresthesia) that is uncomfortable to some patients, while the high frequency generator does not. Replacing a functioning existing generator to high frequency is considered not medically necessary – Confirm your carrier’s policy. CMS also has special billing instructions when a high frequency generator is implanted.
  • Stimwave – This is a wireless stimulator system that combines a receiver and stimulator into one device. An implanted generator is not necessary.
  • StimRouter – Another type of wireless stimulator with an implanted lead and an externally worn power source.
  • PStim or NSS (Neuro Stim System) – Electro Auricular Device or Electro Acupuncture Stimulator This device uses a small battery that is placed behind the ear with stimulating wires that are placed on acupuncture points of the ear.

Coding for these services should be based on current AMA and CPT coding guidelines with consideration being given to your individual carrier policies. Additional coding information will be provided in this month’s webinar.



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