Some people would have you believe that all neurostimulators are coded equally by reporting code(s) for the electrode placement and an additional code for generator placement, but coding will depend on the type of device being implanted.
xWhen we first started coding these types of procedures you would have placement of the electrode array(s) either percutaneously or by open approach. Then a pocket would be developed, the lead(s) would be tunneled to the pocket, connected to the generator and the generator would be implanted into the body. This is when you could report both the lead and generator insertion codes. We now have different devices that consist of lead placement only. The patient then has a wearable antenna and a patient programmer. I will refer you to CPT Assistant Aug. 2018 which states that for this type of device you only report the lead insertion code – you do not report a generator insertion code “because the power-generating device is not implanted internallyâ€.
CODING UPDATE: June 2019
While the information presented in our newsletter was current at the time that it was written, the AMA has since published coding guidance in the May 2019 CPT Assistant – Frequently Asked Questions section which states that “implantation of a percutaneous neurostimulator electrode array with an integrated receiverâ€ should be reported with Unlisted CPT code 64999.