Trial SCS

I need some help with this note.  The patient was having a trial SCS and I coded it with a 63650 per the op note.  The doc also wants to add 63685 and 99152.  Maybe it's the wording throwing me off. 

I placed a electrode lead through the introducer needled with the inferior contact located at the T9 level.  Lead was appropriately placed in posterior epidural space.  I then hooked up the lead to the impulse generator with the rep present.  We got excellent coverage.

I thought for the 63685 you place the battery inside the body/subcutaneous pocket. 

Any thoughts or suggestions with this.


Donna L.


  • Hello, based on the documentation provided you are correct. 63685 (Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling) includes the creation of the subcutaneous pocket and the insertion of the device.

    Here is an excerpt from CPT Assistant, April 2011:

    Code 63685 includes the creation of a subcutaneous pocket made to house the stimulator and tunneling of the electrodes to the pocket. The generator is then placed in the subcutaneous pocket, lead impedances are tested to verify proper connection, and the device is programmed to begin stimulation
    The MAC or carrier policy may specifically state that the trial phase involves an external generator.

    In addition, I don't see any documentation that would justify 99152.

    I hope this helps.

  • Thank you so much.  He's determined to bill with the codes.  I just don't see any supporting documentation.
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