Q&A: How do we report high-frequency neurostimulators?

Q: We have started using what our physicians call “high-frequency” neurostimulators. I know there are two HCPCS codes for reporting these to Medicare, but how do we know what is high frequency and what is not?

A: This has been a common question and CMS has provided clarification in the April OPPS update transmittal. Transmittal 3471 provides more information related to HCPCS C1822 (generator, neurostimulator [implantable], high frequency, with rechargeable battery and charging system). CMS explains that this code was added to describe a “high-frequency spinal cord stimulator operated at 10,000 Hz and paresthesia-free.” This addition was based on a clinical trial supporting that these type of stimulators provide a “substantial clinical improvement” in pain management.

CMS is also changing the description of HCPCS C1820 (generator, neurostimulator [implantable], with rechargeable battery and charging system) back to the original description, removing the “non-high-frequency” specification. The two codes still define which should be used for high-frequency versus those that are not high frequency.

Click here to see the updates to the HCPCS descriptors.

Editor’s note: Denise Williams, RN, CPC-H, senior vice president of revenue integrity services at Revant Solutions, in Fort Lauderdale, Florida, answered this question.