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Simple vs. Complex Brain Neurostimulator Coding Changes 2012

Amy Posted Fri 27th of January, 2012 17:20:42 PM

In 2012, CPT changed the definition of a simple vs. complex neurostimulator. Instead of being defined based on what parameters the stimulators are CAPABLE of changing, they are instead based on how many are ACTUALLY CHANGED during the programming. (3 or less = simple, more than 3 = complex).

There are simple reprogramming code options for spinal cord and peripheral neruostimulators, but not cranial. The only programming option available for cranial is complex.

So my question is....how do I code the procedure if 3 or less parameters are changed on a cranial nerve neurostimulator (like VNS)?

SuperCoder Answered Sun 29th of January, 2012 21:41:43 PM

I think 95974 will work.
95974: Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour
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Please let me know if this answer addressed your question or not.

Amy Posted Mon 30th of January, 2012 15:17:23 PM

But in 95974 it states "complex" cranial nerve neurostimulator, and under the new definition of what "complex" is, if they change less than 3 parameters, wouldn't this now be considered a "simple" programming?

Perhaps they normally change more than 3 parameters with cranial nerve neurostimulators..... I just wasn't sure.

Amy Posted Mon 06th of February, 2012 16:57:13 PM

Any other ideas on this??

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