August 10, 2017

Question:
My surgeon wants to bill 95972 for programming along with placement of a spinal neurostimulator.  Isn’t the programming inclusive to the surgical codes?

Answer:
Good question.  No, the programming is not inclusive to the surgical codes.  However, the billable programming must be real programming and not just a check of the impedance or ensuring the connection of the lead to the generator is working or turning the system on and off.  Billable programming must include documentation of the actual programming parameters such as rate, pulse amplitude, pulse duration, pulse frequency.

Additionally, the programming must be performed by the billing physician.  The physician may not bill for the vendor’s representative doing the programming in the recovery room or in the office.

*This response is based on the best information available as of 08/10/17.