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Neurology & Pain Management Coding Alert

Reader Question:

Choose 95990 for PA Pump Refill Work

Published on Tue Aug 09, 2011

Question: How do we report the service when a physician assistant completes a pump refill? Florida Subscriber Answer: You should submit 95990 (Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal [intrathecal, epidural] or brain [intraventricular]). CPT® includes a companion code in 95991 (... administered by a physician), but you'll only report it when the physician completes the refilling and maintenance. Because a physician assistant is a non-physician provider, his or her services don't qualify for 95991. Reminder: You can also report 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) along with the pump refill code. The provider does not need to make a change in the pump drugs and/or administration rate in order to compliantly report the reprogramming code (62368) at the time of the refill.
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