SCS trial lead removal by physician other than implanter

[NJPAIN]

Is there a TEMPORARY DRG lead removal code for a lead removed by a physician other than the implanter? Obviously, lead removal is inclusive and within the global period for the surgeon. I have a case where the lead was placed by a physician in another practice and patient refused to make the two hour trip to the other MD to remove it. He was at risk for infection so the company rep who was working with me had him come to the ASC and I removed it between cases. No big deal technically to remove it but obviously some liability associated with it. Should have told him I would not do it but I guess I was feeling pius that day.

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[lobelsteve]

Great question, and I think it reasonable to bill a level 3 OV, just document what you did and ask questions/perform exam.

 

[deleted185747]

Bill a level 3 new patient visit for ASC DRG removal? I think not.

I would bill code for removal of leads in this particular case but not make a habit of doing this.

 

[lobelsteve]

That code is surgical removal. Not sliding out trial leads.

 

[NJPAIN]

That code is surgical removal. Not sliding out trial leads.

That is the problem.


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[NOSfan]

If the patient is new to you, then just bill for CNS.

 

[deleted185747]

Then use modifier -52 or -53 and say "I didn't have to cut the patient open and 55% of the procedure was completed"

 

[gdub25]

Agree about this being an office visit. New patient comes to you and you establish patient doctor relationship, treat them with simple removal of medical device. Location of service being an office or ASC makes no difference. Office visit is an office visit as long as there is a chief complaint, HPI, exam and medical decision making isn't it?

 

[gdub25]

Follow-up question to this. What about if you do the trial and the patient comes in 5-7 days later for removal of the trial leads. We can't bill anything for this since it's within the global period correct? No office visit or removal code as I understand it.

 

[lobelsteve]

Follow-up question to this. What about if you do the trial and the patient comes in 5-7 days later for removal of the trial leads. We can't bill anything for this since it's within the global period correct? No office visit or removal code as I understand it.

Correct.

 

[BobBarker]

Hypothetically, what if at lead removal you discussed knee pain and prescribed mobic? Or discussed obesity or smoking cessation? Can you level 3 it then?

 

[lobelsteve]

Isnt it a new patient consult? Doesnt matter what you talk about.

 

[BobBarker]

I am talking about a lead pull on your own patient during the global but another issue besides the scs is addressed.

 

[Ducttape]

yes... but it looks suspicious. provide full documentation on the "other issue".

truth be told, lead pulls take what, 30 seconds? i dont even ask that they be scheduled, because then secretaries et al want to waste an entire time slot on the schedule. no point in that. just show up, gimme a suture removal kit and a bandage...

 

[nvrsumr]

Global is a global I believe

 

[ampaphb]

99203/4/5 with a -22 modifier (https://www.texmed.org/template.aspx?id=22741)

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