CPC

23 Jun 2016

How to code Intrathecal pain pump

Intrathecal Catheter for Pain Management

An intrathecal catheter is a tube that is inserted into the spinal fluid and the other end is buried under the skin and comes out to allow drugs to be given through the catheter.

Drugs (Painkillers) have been given slowly and continuously from a small pump attached to the catheter.

What is an intrathecal pain pump?

An intrathecal pump is a medical device used to deliver medications directly into the space between the spinal cord and the protective sheath surrounding the spinal cord.

What is in a pain pump?

The intrathecal pump system consists of a pump/reservoir implanted between the muscle and skin of your abdomen and a catheter that carries pain medication from the pump to the spinal cord and nerves. The pump is programmed to slowly release medication over a period of time.

Reservoir/Pump Implantation

CPT 62360: Implantation or replacement of device for intrathecal or epidural drug infusion; a subcutaneous reservoir (10 days Global)

CPT 62361: Implantation or replacement of device for intrathecal or epidural drug infusion; a nonprogrammable pump (10 days Global)

            -          Device code C1891 (Infusion pump, non-programmable, permanent (implantable))

CPT 62362: Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming (10 days Global)

            -          Device code C1772 (Infusion pump, programmable (implantable))

     ·         Pocket creation is included with the implanted pump placement

Removal of reservoir or pump

CPT 62365: Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion (10 days Global)

Analysis and/or reprogramming of implantable infusion pump.

CPT 62367: Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill (Global period: XXX)

CPT 62368: Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming (Global period: XXX)

*According to NCCI, programmable pump analysis with or without reprogramming are components of the pump placement (62361, 62362) and therefore not reported together.

CPT 62369: Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill

CPT 62370: Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring the skill of a physician or other qualified healthcare professional)

Refilling and maintenance of reservoir or pump without reprogramming.

CPT 95990: Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump when performed.

CPT 95991: Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump when performed; requiring the skill of a physician or other qualified healthcare professional    

Tunnelled Catheter Placement.           

Report CPT 62350, 62351 only if this is a tunnelled catheter; percutaneous placement is reported with the injection codes

Report additional codes for pump placement.
           
Catheter Implantation

CPT 62350: Implantation, revision or repositioning of tunnelled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy (10 days Global)

CPT 62351: Implantation, revision or repositioning of tunnelled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy   (90 days Global)

           -          Device code C1755 (Catheter, intraspinal)


Note: CY 2011 DEVICES FOR WHICH THE “FB” OR “FC” MODIFIER MUST BE REPORTED WITH THE ASC PROCEDURE CODE WHEN FURNISHED AT NO COST OR WITH FULL OR PARTIAL CREDIT.


Removal of intrathecal catheter

CPT 62355: Removal of previously implanted intrathecal or epidural catheter. (10 days Global)


Note: Medicare provides C-codes for hospital use in billing Medicare for medical devices in the outpatient setting. Although other payers may also accept C-codes, regular HCPCS II device codes are generally used for billing non-Medicare payers. ASCs, however, usually should not assign or report HCPCS II device codes for devices on claims sent to Medicare. Medicare generally does not make a separate payment for devices in the ASC. Instead, payment is “packaged” into the payment for the ASC procedure. ASCs are specifically instructed not to bill HCPCS II device codes to Medicare for devices that are packaged.


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