Permanent Spinal Cord Stimulator Placement

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August 4, 2016

Question:
Our pain management doctor did a trial spinal cord neurostimulator electrode placement a month ago. Our neurosurgeon is now placing the permanent electrode, via laminectomy, along with the generator. Do we need to use modifier 58 on the neurosurgeon’s codes?

Answer:
Modifier 58 is used on the procedures performed within a global period for a previous procedure when the second and subsequent procedures are planned/anticipated, or more extensive than the original procedure, or for therapy following a surgical procedure. However, the postoperative global period for the trial electrode placement (63650) is 10 days. Your neurosurgeon is placing the permanent system a month afterward; therefore, a global period modifier such as 58 is not necessary. Another reason why a global period modifier is not necessary is because the neurosurgeon is not in the pain management physician’s global period since they are of different specialties.

*This response is based on the best information available as of 08/04/16.

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