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Cherie Posted Fri 15th of July, 2016 08:09:40 AM
Our doctor did the procedure for an interstim revision of generator pocket (64595) and he did a removal and replacement of InterStim sacral neuromodulation lead. The lead was removed in its entirety then he did intraoperative testing of the patient's S3 nerve root on each side via needle stimulation under fluoroscopic imaging. Best responses were left side. Then after that the skin nick incision was mad and the obturator and cannula was then advanced over the insertion guide and positioned to the deep aspect of the sacral bone plate. Repeat intraoperative testing confirmed appropriate S3 response at all four contact points at low power settings. Under real time fluoroscopy, the tines were deployed. The lead was tunneled through the deep subcutaneous pathway to the patient's newly revised generator pocket and then secured to the patient's previous generator. Our question is, he says that removal and then replacement of a new lead is represented by 64581. We feel that it is 64585. Would you be able to clear this confusion up? We have read the Urology coding alert in regards to this situation. Thanks so much.
SuperCoder Answered Mon 18th of July, 2016 08:03:03 AM
Hi Cherie, Since the provider has done removal and replacement of InterStim sacral neuromodulation lead as per documentation, so it will be appropriate to use CPT 64585 ( Revision or removal of peripheral neurostimulator electrode array). Thank You.

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