Beatriz Posted Fri 20th of September, 2019 15:27:20 PM
Need correct code for a new service in the office. It is a Percutaneous Electrical Nerve Stimulation Therapy by DyAnsys (Impl Neurostimulator Pulse Gen) stating the code is L8679 for the device. Is there another procedure code for the procedure? 64999 or S8930? Can we only bill the L8679 alone? we are billing globally done in the office place of service 11.
SuperCoder Answered Mon 23rd of September, 2019 09:50:13 AM
Thanks for your question.
Percutaneous electrical nerve stimulation (PENS) refer to combination of electroacupuncture and transcutaneous electrical nerve stimulation (TENS). PENS therapy uses needle-like electrodes that are placed in close proximity to the painful area and stimulate peripheral sensory nerves in the soft tissue.
An implantable neurostimulator pulse generator is an electronic device that emits electric impulses, which travel to the spinal cord to relieve pain. The device consists either of an external power source or internal battery and a set of leads that a provider affixes to the epidural space of the spinal cord or peripheral nerves. The device modifies pain signals before they reach the brain, resulting in pain relief.
Code L8679 code covers an implantable neurotransmitter pulse generator to initiate electrical impulses that relieve chronic pain.
S8930 code covers electrical stimulation of acupuncture points on the external ear that the provider spends stimulating auricular acupuncture points.
According to BCBS policy, correct CPT code to use for PENS is unlisted code 64999. Also, CPT codes for percutaneous implantation of neurostimulator electrodes are not appropriate since PENS use percutaneously inserted needles and wires rather than percutaneously implanted electrodes. The stimulation devices used in PENS are not implanted so CPT code 64590 is also not appropriate.
Kindly check your payer policy about use of unlisted code for percutaneous electrical nerve stimulation.
Hope this helps.
Beatriz Posted Fri 27th of September, 2019 11:00:21 AM
The CPT code for the PENS is 64999 is there another code for doing the procedure with the device? The Neurostimulator provides continuous low-level electrical pulses at the ear for up to seven days. A new Neurostimulator is applied on a biweekly basis for the duration of the therapy. Are the new Neurostimulators considered inclusive or can it be separately billed.
SuperCoder Answered Mon 30th of September, 2019 11:18:03 AM
As per the CMS,
Providers are required to bill procedure codes that exactly describe the service performed and currently there are no specific Current Procedural Terminology® (CPT®) codes for PENS or PNT. Therefore, unlisted CPT® code 64999 (Unlisted procedure, nervous system) should be used to report percutaneous electrical nerve stimulation and percutaneous neuromodulation therapy.
CPT® code 64999 billed for percutaneous neuromodulation using a percutaneous electrode array (e.g., BioWave) has been evaluated by WPS GHA (payor) and deemed a noncovered service.
Therefore, there is insufficient evidence to support coverage of Biowave’s Deepwave percutaneous neuromodulation pain therapy system at this time. Any ear or auricular electrical devices (e.g., DyAnsys®) are also non-covered by Medicare as electrical acupuncture. Any other device that is taped on, surgically not implanted next to the nerve, or a device that is subcutaneous is non-covered as well.
The medical necessity and patient's medical record must contain the documentation for the use of neurostimulator for the duration and to consider the neurostimulator to be inclusive or separately billed the payor policy.
You can also refer to the below mentioned link for the details:
Hope this helps.
Beatriz Posted Thu 24th of October, 2019 13:35:44 PM
The procedure is 64999. What is the code for the Device?
SuperCoder Answered Fri 25th of October, 2019 10:00:35 AM
Hi Thanks for your question nbsp You will need to check with your payer if authorization is required and what their medical policy criteria is for PENS nbsp Some payer may accept billing CPT code for procedure and L for implant nbsp nbsp Also HCPCS code S is used by...
Beatriz Posted Fri 25th of October, 2019 14:48:41 PM
Are you sure the L8679 is the proper code for the device, because you mentioned before it was not.
SuperCoder Answered Tue 29th of October, 2019 08:25:10 AM
Hi The code can be billed after checking with your payer for rules and regulations for the device Also we suggested that some payers may also accept code S for both professional and technical component however as stated earlier this code is not payable by Medicare So if your payer...