Healthcare Fraud Shield’s Latest Article: The Stimulating Billing of P-Stim devices!

3 Dec

 

We all want to be pain free right? What if I told you that you could experience relief of chronic pain using a minimally invasive technique with virtually no side effects? You would probably say sign me up, right? At least that’s what the makers of P-Stim devices like ANSiStim and Stivax are advertising.

What is P-Stim?

Point-Stimulation Therapy or P-Stim is a non-narcotic approach to pain management. P-Stim is a miniaturized electro-acupuncture device worn by the patient that administers continuous pulses of a low-level electrical current at the ear over several days. Electrical pulses are emitted through three selectively positioned acupuncture needles.

Some examples of the devices include:

  1. AcuStim (S.H.P. International)
  2. P-Stim™ System (NeuroScience Therapy)
  3. E-pulse® (AMM Marketing)
  4. Electro Auricular Device – EAD (Key Electronics)
  5. P-Stim (Biegler Gmbh)
  6. ANSiStim® (DyAnsys)
  7. Stivax System (Biegler Gmbh)

Who should use a P-Stim?

Makers of the PStim devices advise that using P-Stim can be highly effective in relieving chronic pain for conditions such as:1

  • Peripheral Vascular Disease
  • Neuropathy
  • Post-amputation Pain
  • Herpetic Neuralgia
  • Trigeminal Neuralgia
  • Reflex Sympathetic Dystrophy (RSD)
  • Migraines
  • Occipital Neuralgia
  • Peripheral Artery Disease (PAD)
  • Back and Neck Pain
  • Post-Surgical Pain
  • Complex Regional Pain Syndrome (CRPS)
  • Diabetic Peripheral Neuropathy
  • Lateral Femoral Cutaneous Neuropathy
  • Traumatic Nerve Injuries

Can anyone place a P-Stim device?

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.

If you have any questions or comments, please contact SIU@hcfraudshield.com.
REFERENCES

[1,]P-Stim

[2]Medicare/DOJ

If you would like to learn more about Healthcare Fraud Shield’s PostShield Shared Analytics, contact us at info@hcfraudshield.com.  

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