Billing for a Neurostimulator Implant

Question:

My physician billed implanted a neurostimulator into the sacral nerve for urinary incontinence. We billed CPT codes 64562 and 95972 for a Medicare patient. Medicare denied CPT 95972 for the analysis and programming. My physician says it should be paid and we should appeal. Can you provide advice?

Answer:

Based on CPT guidance (February CPT Assistant 2019; “When a neurostimulator or its components is implanted, electronic analysis is inherently included as part of the implantation procedure.” You cannot report the analysis and programming of a neurostimulator on the same date of service as it is included in the implantation of the device.