Looks like CMS will bundle the SCS L code for office trials but of course not in the hospital or ASC......
There is a link below to makes public comments to CMS
Summary of the Issue
On Friday, July 6, 2012 CMS released the 2013 Medicare Physician Fee Schedule and is proposing changes to coding and reimbursement for Spinal Cord Stimulation (SCS) trialing in an office setting, also referred to as a non-facility setting. The proposed changes also affect coding and reimbursement for disposable leads, which CMS considers resource costs. As such, CMS believes they should be incorporated as non-facility direct Practice Expense (PE) inputs with other disposable medical supplies.
In their release, CMS stated that CPT code 63650 is frequently furnished in the office setting, but because there are no relative value units (RVUs) for the non-facility setting, it is not priced accordingly. CMS has proposed to establish values for 63650 in an office setting and has requested input from the AMA RVU update committee (RUC) and others to value the code appropriately.
This information is proposed, and will be finalized based on public input to the proposals. The final rule will be published around November 1, with implementation for 1/1/2013. Comments can be submitted via: http://www.regulations.gov/#!documentDetail;D=CMS-2012-0083-0075 - follow the link and click the blue "Comment Now!" box
CMS is proposing to:
 Bundle the cost of the lead into the procedure code 63650, and establish appropriate practice expense within the office setting.
 Establish values for physician practice expense for SCS trials in the office setting
 Suggest that L8680 is not the appropriate code for billing for trial leads in the office setting
 Seek comments on the appropriate value of 63650, particularly the non-facility practice expense (supplies, equipment, etc.) RVUs AND the physician work value (time and intensity) in all settings.
 Seek comments or guidance on the appropriate valuation of the supplies (disposable leads) used during 63650 in an office setting.
CMS is soliciting public feedback on the proposal. What are their questions?
 How should CPT 63650 be valued in the office setting?
 Currently there is an RVU work value established for CPT 63650. What is the appropriate physician time and intensity (RVU work value) to perform this procedure in the office or facility setting?
 What is the correct value for the disposable lead?
 What should be captured within the non-facility practice expense that is different than the facility practice expense for CPT 63650?
 What else should CMS keep in mind when establishing appropriate RVU values for CPT 63650 in the office setting?
How do I comment?
 Comments are accepted until 4 PM ET on September 4, 2012.
 Comments can be submitted via: http://www.regulations.gov/#!documentDetail;D=CMS-2012-0083-0075 Follow the link and click the blue "Comment Now!" box
We are collaborating with societies, industry, and individual physicians to respond to this proposal. Medtronics reimbursement team can provide more detail on this and other policy proposals, including information on how to respond to the proposed rule. Please contact your local Health Economics Manager for assistance.
Additional information regarding proposals affecting Medtronic Neuromodulation implantable pump therapies will be available separately from your Health Economics Manager.
Source: Medicare Physician Fee Schedule (MPFS) 2013 Proposed Rule, p 49 of display version www.cms.gov, July 6, 2012. http://www.gpo.gov/fdsys/pkg/FR-2012-07-30/pdf/2012-16814.pdf p. 14, 77 FR 44734
There is a link below to makes public comments to CMS
Summary of the Issue
On Friday, July 6, 2012 CMS released the 2013 Medicare Physician Fee Schedule and is proposing changes to coding and reimbursement for Spinal Cord Stimulation (SCS) trialing in an office setting, also referred to as a non-facility setting. The proposed changes also affect coding and reimbursement for disposable leads, which CMS considers resource costs. As such, CMS believes they should be incorporated as non-facility direct Practice Expense (PE) inputs with other disposable medical supplies.
In their release, CMS stated that CPT code 63650 is frequently furnished in the office setting, but because there are no relative value units (RVUs) for the non-facility setting, it is not priced accordingly. CMS has proposed to establish values for 63650 in an office setting and has requested input from the AMA RVU update committee (RUC) and others to value the code appropriately.
This information is proposed, and will be finalized based on public input to the proposals. The final rule will be published around November 1, with implementation for 1/1/2013. Comments can be submitted via: http://www.regulations.gov/#!documentDetail;D=CMS-2012-0083-0075 - follow the link and click the blue "Comment Now!" box
CMS is proposing to:
 Bundle the cost of the lead into the procedure code 63650, and establish appropriate practice expense within the office setting.
 Establish values for physician practice expense for SCS trials in the office setting
 Suggest that L8680 is not the appropriate code for billing for trial leads in the office setting
 Seek comments on the appropriate value of 63650, particularly the non-facility practice expense (supplies, equipment, etc.) RVUs AND the physician work value (time and intensity) in all settings.
 Seek comments or guidance on the appropriate valuation of the supplies (disposable leads) used during 63650 in an office setting.
CMS is soliciting public feedback on the proposal. What are their questions?
 How should CPT 63650 be valued in the office setting?
 Currently there is an RVU work value established for CPT 63650. What is the appropriate physician time and intensity (RVU work value) to perform this procedure in the office or facility setting?
 What is the correct value for the disposable lead?
 What should be captured within the non-facility practice expense that is different than the facility practice expense for CPT 63650?
 What else should CMS keep in mind when establishing appropriate RVU values for CPT 63650 in the office setting?
How do I comment?
 Comments are accepted until 4 PM ET on September 4, 2012.
 Comments can be submitted via: http://www.regulations.gov/#!documentDetail;D=CMS-2012-0083-0075 Follow the link and click the blue "Comment Now!" box
We are collaborating with societies, industry, and individual physicians to respond to this proposal. Medtronics reimbursement team can provide more detail on this and other policy proposals, including information on how to respond to the proposed rule. Please contact your local Health Economics Manager for assistance.
Additional information regarding proposals affecting Medtronic Neuromodulation implantable pump therapies will be available separately from your Health Economics Manager.
Source: Medicare Physician Fee Schedule (MPFS) 2013 Proposed Rule, p 49 of display version www.cms.gov, July 6, 2012. http://www.gpo.gov/fdsys/pkg/FR-2012-07-30/pdf/2012-16814.pdf p. 14, 77 FR 44734
