AHA Coding Clinic® for HCPCS - 2014 Quarter 2; Ask the Editor
InterStim generator pocket repositioning
A patient was seen at our facility for a pocket repositioning of an InterStim generator. Our coders have a dilemma regarding the correct code assignment for this procedure. Neither the generator device nor lead was replaced or repaired, so what would be the correct CPT procedure code assignment for repositioning of the pocket only? If the repositioning of the pocket is performed at the same time as the lead placement, would the repositioning be reported in addition to the placement of the lead? ...
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Article Overview
This article discusses how to approach CPT reporting for an InterStim generator pocket repositioning scenario and whether additional reporting is appropriate when pocket work occurs with lead placement. It is aimed at coding professionals who need to understand how the procedure is categorized and what broad coding guidance applies in the absence of a specific descriptor.
Why This Topic Matters
Facility coders and auditors may encounter sacral neuromodulation procedures that involve pocket revision or relocation without device replacement, and the article explains the coding framework used to address that situation.
What You Will Learn
- How an InterStim generator pocket repositioning scenario is categorized for CPT reporting.
- How to think about reporting when pocket work occurs alongside lead placement.
- How unlisted procedure coding may apply when no specific CPT descriptor is available.
- The general coding considerations involved in device pocket relocation cases.
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle staff
- Outpatient facility coding staff
Codes Discussed
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