Check your respective state guidelines and internal policies, but typically only licensed medical providers may apply this device.
How is it billed?
S8930-Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient.
The Potential Scheme
Medicare does not reimburse for acupuncture or for acupuncture devices such as P-Stim, nor does Medicare reimburse for P-Stim as a neurostimulator or as implantation of neurostimulator electrodes. Medicare considers Electrical stimulation of auricular acupuncture not medically necessary and not covered for all indications, including but not limited to chronic and acute pain.2
P-Stim is sometimes incorrectly billed as a surgically implanted neurostimulator (HCPCS code L8679). The American Medical Association defines code L8679 as an "Implantable Neurostimulator, Pulse Generator." P-stims are applied as devices employing acupuncture needles attached to electrodes that are being applied to a patient's ear through simple bandages and therefore does not qualify as "implantable".
Implantation of a Percutaneous Neurostimulator Pulse Generator is typically performed in an outpatient or Ambulatory Surgical Center (ASC) setting while P-stims can generally be performed in an office environment.
Auditors and investigators should:
1)
Review claims to determine the place of service and if an implantable neurostimulator is being billed without an accompanying surgical code as this might imply the provider is incorrectly reporting P-Stim.
2)
Look for excessive billing of L8679
3)
Look for S8930 with a place of service for ASC.
