Incorrect Billing of HCPCS L8679 - Implantable Neurostimulator
CMS has issued a MLN (Medicare Learning Network) article concerning the inappropriate reporting of HCPCS supply code L8679 (Implantable neurostimulator, pulse generator, any type) for electro-acupuncture devices. These devices are applied behind the ear using an adhesive and/or with needles inserted into the patient's ear and do not require surgical implantation.
Code L8679 should only be reported with procedures that require surgical implantation into the central nervous system or targeted peripheral nerve. These procedures are usually performed in an operating room. The MLN article (number SE2001) provides a list of appropriate procedures that must accompany any claims that include code L8679. It can be accessed here.
As of March 1, 2020, claims billed with HCPCS L8679 must be billed with the same date of service as the applicable surgical procedure code. Claims for code L8679 reported with an appropriate surgical code will be suspended for medical review to verify that coverage, coding, and billing rules have been met. Claims submitted without an appropriate procedure code will be rejected.
Please make sure your coding and billing staff are aware of the correct use of code L8679 and the changes in the CMS policy. The National Coverage Determination Manual Section 160.7 on implanted peripheral nerve stimulators is available here.