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New urology code tied to only one device and vendor

Image used with permission from UroplastyUrologists have a new code to describe posterior tibial neurostimulation, which was previously billed using unlisted code 64999. However, it's slow going for the new code, 64566 (posterior tibial neurostimulation, percutaneous needle electrode, single treatment, $129.11). There is currently only one device on the market that can perform the procedure -- the Urgent PC, manufactured by Minnesota-based Uroplasty.

The new code "is not device-specific ... if another comparable device comes out, then the same code would be used," says Stephanie Stinchcomb, CPC, senior manager for reimbursement and regulation at the American Urological Association in Linthicum, Md. What's more, 64566 is not covered by a national coverage determination (NCD) -- it's up to your individual carrier to specifically cover it via the local coverage determination (LCD) process.

You'll need to check with your carrier for the last word, though Uroplasty's website offers a starting point to find reimbursement information.

This is another case where a new device is being brought out into the market, with spotty Medicare coverage. However this particular device seems destined for a better fate than that which befell the NC-Stat, a small, electronic hand-held device. The NC-Stat could supposedly perform nerve conduction tests that were just as clinically useful as those done by much larger, older devices costing many times more. But CPT didn't play along and the NC-Stat is now practically unbillable, and for practices who bought on, very tough to sell. Fortunately for Uroplasty, they've got their own CPT code from the get-go, and it describes what the Urgent PC does almost verbatim from their product page.
Blog Tags: MACs, vendors
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