Percutaneous Tibial Nerve Stimulation (PTNS) for treatment of Overactive Bladder: How should this be billed?
Our research shows PTNS is an alternative to sacral nerve stimulation, but PTNS is still investigational. Therefore, Medicare would not cover this service. Providers have reported they have been advised to code this with CPT code 64555, percutaneous implantation of neurostimulator electrodes, peripheral nerve. Since CPT code 64555 does not involve ”implantation” but simply the insertion of an electrode for temporary stimulation, providers should instead bill CPT code 64999. Claims for this will be denied as lack of medical necessity with provider liability unless the patient is informed prior to the service and signs an appropriate ABN assuming responsibility for payment of the service.
