May 31, 2018
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. This code requires a 7th digit and we are struggling with the difference between initial encounter (A) and subsequent encounter (D) for this case. It’s not an injury or fracture which makes it more difficult to decide. Can I get your expertise?
A couple of questions/ comments about this:
- Why are the leads being replaced? Are they dislodged or out of place? If so, then a T code is appropriate.
- For routine battery replacements because the battery has reach its end of life (a normal occurrence – not a complication), we’d use the condition code such as Parkinson’s disease (G20) and not a T code.
If you’re using a T code then you have 3 choices for the 7th character: A for initial encounter, D for subsequent encounter, and S for sequela. The service is not being performed for a sequela so you can eliminate the 7th character of S. So now you’re between A and D. Since the patient is receiving active treatment for the “other mechanical complication”, you’ll use the 7th character of A (T85.190A).
*This response is based on the best information available as of 05/31/18.