Permanent Spinal Cord Stimulator Placement

August 4, 2016

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?

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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