GUIDEPOINT Reimbursement Resources: FY 2016 Quick Reference Guide Neuromodulation Inpatient Hospital Coding and Payment Guide for Spinal Cord Stimulation

Spinal Cord Stimulation (SCS) Procedures Coding and Payment Guide

This guide provides information on Medicare coding and base payment rates for SCS procedures performed in the inpatient hospital setting for FY 2016.

ICD-10 Transition

CMS has mandated the use of ICD-10-CM for diagnosis codes and ICD-10-PCS for inpatient procedures as of October 1, 2015.

ICD-10 Procedure Codes for SCS

The guide outlines ICD-10-PCS codes for SCS procedures, including insertion of neurostimulator leads and generators.

MS-DRGs Associated with SCS

The guide lists MS-DRGs associated with SCS procedures, including implantation of SCS system leads and multi-array pulse generators.

Medicare National Coverage Determination

Medicare has a National Coverage Determination (NCD) for electrical nerve stimulators, including specific criteria for coverage of spinal cord stimulation.

Manual:

Download: GUIDEPOINT Reimbursement Resources: FY 2016 Quick Reference Guide Neuromodulation Inpatient Hospital Coding and Payment Guide for Spinal Cord Stimulation