Spinal Cord Stimulation Coding and Payment Guide

This guide provides Medicare coding and national physician payment rates for spinal cord stimulation procedures, including lead and pulse generator placement, revision, and removal codes.

Medicare National Coverage Determinations

Medicare has a longstanding National Coverage Determination (NCD) for electrical nerve stimulators, including specific criteria for coverage, such as the implantation of the stimulator being used only as a last resort for patients with chronic intractable pain.

Indications for Use

The Boston Scientific Spinal Cord Stimulator Systems are indicated as an aid in the management of chronic intractable pain of the trunk and limbs, including unilateral or bilateral pain associated with various conditions.

Contraindications and Warnings

The SCS Systems are contraindicated for patients who are unable to operate the SCS System, have failed trial stimulation, or are poor surgical candidates.

Manual:

Download: 2024 Quick Reference Guide Spinal Cord Stimulation Physician Reimbursement 2024 Coding and Payment Guide for Medicare Reimbursement

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