AHA Coding Clinic® for HCPCS - 2011 Issue 3

Clarifications/Corrections

In the fourth quarter 2010 issue of AHA’s Coding Clinic for HCPCS, question #1, page 4, a patient underwent a staged implantation of an intracranial neurostimulator system. During the first stage, the patient had right and left leads placed in the brain. The patient later returned for placement of lead extensions as well as right and left generators. The published guidance stated that placement of the lead extensions are captured in the code for the generator placement. At our facility we get these types of cases quite frequently, and our coders are always advised not to code the extensions separately, that they are included in the generator code. Our issue is regarding the recommended CPT code 61886, Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays, of which we were instructed to report for the placement of both the right and left generators. According to the question, the generators were separately placed and we believe should be appropriately reported with CPT code 61885, Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array, with the appending of Modifier 50.  Please note: CPT code 61886 would be assigned for placement of a single generator connected with two leads. ...

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