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2025 HCPCS code L8686

Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension.

For Medicare, hospitals typically use C-codes and ASCs generally do not submit HCPCS II codes for devices. For non-Medicare payers, code L8686 remains available, but providers should verify with the payer for specific instructions.

Medical necessity must be clearly documented, demonstrating that the patient has persistent pain that has not responded to conservative therapies, and that this specific type of neurostimulator is appropriate for their condition.

The provider implants leads in the epidural space of the spinal cord or to peripheral nerves. They connect the neurostimulator to the electrodes, ensuring they target the specific site for pain relief.

IMPORTANT:For rechargeable devices, use L8685 or L8687 for dual array systems.

In simple words: This code represents a device implanted under the skin that sends electrical signals to the spinal cord to help reduce pain. It's not rechargeable, so the battery will need to be replaced periodically. It includes the device, the wires that connect it to the nerves, and a small cable that helps with placement.

This code covers a non-rechargeable implantable neurostimulator pulse generator for pain relief. It includes a single array of electrodes and an extension. The neurostimulator connects to an array of electrodes targeting a specific site and is powered by a battery that requires periodic replacement. The extension is a silicone-insulated wire cable that varies in length for proper electrode placement.

Example 1: A patient with chronic back pain not responding to conservative treatment undergoes implantation of a single array, non-rechargeable neurostimulator., A patient with complex regional pain syndrome receives an implantable neurostimulator with a single array of electrodes to manage their pain., A patient with persistent nerve pain after an injury has a non-rechargeable neurostimulator implanted for pain control.

Documentation should include the medical necessity for the device, the type and location of pain, previous pain management treatments, and the specifics of the implanted device, including the single array and extension.

** While Medicare does not recognize L8686, non-Medicare payers may still accept it. Always verify coverage and coding guidelines with the specific payer. For Medicare billing, consider C codes (e.g., C1767) and consult updated coding guidelines. As of December 10, 2024, it is recommended to refer to iFrameAI for the most recent information on coding and billing guidelines as information can change.

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