| Code | Description |
|---|---|
| 64566 | POSTERIOR TIBIAL NEUROSTIMULATION, PERCUTANEOUS NEEDLE ELECTRODE, SINGLE TREATMENT, INCLUDES PROGRAMMING |
What is procedure code 64566?
Code. Description. 64566. POSTERIOR TIBIAL NEUROSTIMULATION, PERCUTANEOUS NEEDLE ELECTRODE, SINGLE TREATMENT, INCLUDES PROGRAMMING.
Is percutaneous tibial nerve stimulation covered by Medicare?
While PTNS is covered by Centers for Medicare & Medicaid Services (CMS), coverage varies amongst commercial insurers and providers may want to have the procedure pre-certified to ensure coverage.
What is posterior tibial neurostimulation?
Posterior tibial nerve stimulation (PTNS) is a form of neuromodulation – i.e. it aims to change the abnormal pattern of stimulation of the nerves that supply the bladder and pelvic floor. Bladder and pelvic floor muscle function is co-ordinated in the lower part of the spinal cord by the sacral nerves.
Who can perform PTNS?
PTNS is considered reasonable and necessary when the following criteria are met: • An evaluation by an appropriate specialist, usually a urologist or urogynecologist, has been performed and the specialist has determined that the patient is a candidate for PTNS; and • The medical record documents that the beneficiary ...
Is Sacral Nerve Stimulation covered by Medicare?
Medicare will cover SNS for patients with urinary urge incontinence, urgency-frequency syndrome and urinary retention.
How does tibial nerve stimulation work?
The nerve stimulation leads to decreased urgency and urination. At each session of stimulation, the needle is attached to a small device that sends mild electrical pulses through the tibial nerve. These pulses help block the nerve signals that are causing the bladder to be overactive.
Where is the posterior tibial nerve?
At the level of ankle, the posterior tibial nerve can be found midway between the medial malleolus and the heel.
Where is the tibial nerve?
The tibial nerve starts above the knee in the back of the leg. As it travels downward, it branches off to innervate muscles in the hamstrings. Continuing toward the heel, the sural nerve branches off, which innervates the calf. Once the tibial nerve reaches the foot, it passes through the tarsal tunnel.
Is the tibial nerve motor or sensory?
The tibial nerve originates from the L4-S3 spinal nerve roots and provides motor and sensory innervation to most of the posterior leg and foot. In addition to its motor branches, the branches of the tibial nerve include the medial sural cutaneous nerve, medial calcaneal nerve, and the medial and lateral plantar nerves.
What is the cost of PTNS?
Base-case economic model resultsTreatmentUIEs (PPPY)Total costsPTNS1359$14,103Mirabegron (25 mg)1464$14,745Mirabegron (50 mg)1462$14,738Tolterodine ER (4 mg)1472$12,7765 more rows•Dec 4, 2018
How successful is PTNS?
Results. PTNS was found to be effective in 37-100% of patients with OAB, in 41-100% of patients with NOUR and in up to 100% of patients with CPP/PBS, children with OAB/dysfunctional voiding and patients with neurogenic pathologies. No major complications have been reported.
Can you do PTNS at home?
Self-management at home offers the potential for TTNS to be a cost-effective alternative to the minimally invasive Percutaneous Tibial Nerve Stimulation (PTNS) which delivers stimulation via single-use needles inserted by a healthcare practitioner [5].
Document Information
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
This LCD supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for posterior tibial nerve stimulation (PTNS). Federal statute and subsequent Medicare regulations regarding provision and payment for medical services are lengthy.
Coverage Guidance
Compliance with the provisions in this policy may be monitored and addressed through post payment data analysis and subsequent medical review audits. History/Background and/or General Information Posterior Tibial Nerve Stimulation (PTNS), a minimally invasive procedure, consists of insertion of a percutaneous needle above the medial malleolus into a superficial branch of the posterior tibial nerve.
Effective July 1, 2016
Posterior Tibial Nerve Stimulation (PTNS) is a minimally invasive neuromodulation system designed to deliver retrograde electrical stimulation to the sacral nerve plexus through percutaneous electrical stimulation of the posterior tibial nerve.
PTNS Procedure Description
The posterior tibial nerve contains mixed sensory motor nerve fibers that originate from L4 through S3, which modulate the innervation to the bladder, urinary sphincter and pelvic floor.
Coverage Guidelines
Consistent with Noridian, manufacturer instructions, and existing literature descriptions of appropriate clinical usage, Noridian expects this treatment to be (generally) delivered in an office setting (Place of Service 11) and that the standard treatment regimen will consist of one 30-minute sessions given once weekly for 12 weeks.
