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Old 07-24-2008, 11:22 AM
nc_coder nc_coder is offline
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Question coding on-q pain pump insertion

One of my physicians turned in a charge for insertion of an On-Q pump with a Laparoscopic Hernia Repair. Does anyone know if I can bill for this and if so, how?
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Old 07-24-2008, 04:46 PM
heathermc heathermc is offline
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we use 11981 when we charge for pain pumps
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Old 07-28-2008, 06:19 PM
racosta racosta is offline
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Default coding for pain pumps

We have been told by the On-Q rep to use unlisted codes. For example, if we place an On-Q with an inguinal hernia repair we would bill 49999 for the pain pump. Most insurance companies will pend the claim for review. It took an average of 45 days to get the claim paid. Cigna has advised us that 11981 is more appropriate than an unlisted code. Needless to say we are billing 11981 to Cigna.
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Old 07-30-2008, 09:54 AM
kknapp kknapp is offline
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Default on q pain pump insertion

Here are the codes that are used for the pump inserts

64416 – brachial plexus
64446 – sciatic nerve
64448 – femoral nerve
64449 – lumbar plexus
76942 – ultrasound guided (different revenue code) (no separate payment, it is included in codes above
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Old 08-01-2008, 10:11 AM
brozier brozier is offline
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racosta, has Cigna paid the 11981? What other ins companies have you billed it to and have they paid it? I have had some ins companies pay the 49999 after sending in documentation and appealing it. Some BCBS and some of the no name private insurances. Thanks
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Old 08-07-2008, 12:22 AM
JillT1 JillT1 is offline
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Question

Quote:
Originally Posted by racosta View Post
We have been told by the On-Q rep to use unlisted codes. For example, if we place an On-Q with an inguinal hernia repair we would bill 49999 for the pain pump. Most insurance companies will pend the claim for review. It took an average of 45 days to get the claim paid. Cigna has advised us that 11981 is more appropriate than an unlisted code. Needless to say we are billing 11981 to Cigna.
As a payer, we have chosen to adopt CPT ciode 11981 for the On-Q pain pump. My question is this; How did Cigna communicate to you as a provider that they required this code when billing an On-Q? As a rule, we don't tell our providers how to bill, however, if there is a way to communicate this to our network of providers, I would be most grateful for any direction anyone can give. Thanks for your help!!!
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Old 08-12-2008, 10:01 AM
nc_coder nc_coder is offline
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Quote:
Originally Posted by kknapp View Post
Here are the codes that are used for the pump inserts

64416 – brachial plexus
64446 – sciatic nerve
64448 – femoral nerve
64449 – lumbar plexus
76942 – ultrasound guided (different revenue code) (no separate payment, it is included in codes above
Thanks for your reply. I have researched these codes. I don't think any of these would be what I am looking for. My physicians use this pump with abdominal surgeries and state it was placed in the "preperitoneal space". I didn't see any mentioned above that would fit that description.
Thanks again for your help.
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Old 08-14-2008, 08:27 PM
ARCPC9491 ARCPC9491 is offline
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I have read that 11981 doesn't "accurately the describe the service" - it has nothing to do with pain control. I wish I could find that article. That's interesting that Cigna uses it.....hmmmm.
My plastics doc wanted to bill it and I believe I found the article in a plastics magazine that said do not use... even though it's a pain to bill the unlisted code, that's the way we've been doing it.....
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Old 06-07-2012, 09:45 AM
Shelleybernstein Shelleybernstein is offline
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Default coding on a q pain pump removal

I am looking for any documentation to determine when it would be appropriate to bill for q pain pump removal by a physician or PA.

Specifically is this usually only billed when a patient is given some type of sedation or can it be appropriately billed at any time?
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Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

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