Full Answer
This is the doctors notes for the procedure and Dx: CPT-4 and ICD-10 codes for Spinal Cord Stimulator pulse generator (battery) replacement, for a diagnosis of Spinal cord stimulator malfunction, battery end of life and failed back surgery syndrome. - I believe that the CPT code should be 68635 but I'm not sure about the ICD codes.
ICD-10-CM Code for DBS Battery/Generator Replacement. We are using the diagnosis code of T85.190 (Other mechanical complication of implanted electronic neurostimulator of brain electrode (lead), initial encounter) for the replacement of a deep brain stimulator generator (2 leads, 61886) because the battery died.
It is expected that a battery will last only so long so replacing it is not considered a “complication” when replacement is needed. You could also report Z45.49 (Encounter for adjustment and management of other implanted nervous system device) as a secondary diagnosis code but it would not be the primary diagnosis.
(ICD-10-CM Official Guidelines for Coding and Reporting FY 2021, I.C.21.c.7). 7. Code Z96.82 is a status code, assigned to indicate that the patient currently has an implanted neurostimulator that was placed during a prior encounter.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
This First Coast Billing and Coding Article for Local Coverage Determination (LCD) L36035 Spinal Cord Stimulation for Chronic Pain provides billing and coding guidance for frequency limitations as well as diagnosis limitations that support diagnosis to procedure code automated denials.
All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.
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