62368 POS12 issue

sharonc2222

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We have a patient with an intrathecal pump that needed to be seen at home. The doctor analyzed and reprogrammed the pump. We billed 62368 and Medicare denied saying that the home (POS12) is an inappropriate place of service. The pumps are often refilled at home and we bill 62370 without any issues. Not quite sure why Medicare says it's an inappropriate POS. It's considered a surgical code, but so is 62370. Anyone have any ideas? And does anyone know if you can appeal with Medicare and actually get paid?
 
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chennai
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What is reprogramming of Intrathecal PUMP?

I am eager to understand What is the actuall difference in Codes 95990-95991 and 62370, as per cpt code description they diffier 95990-91 are refill without reprogramming and 62370 is with refill and reprogramming. I have a physician who documents procedure note heading as refill and reprogramming of IT pump. But in documentation reprogramming was not documented at all. I was dinged couple of times when i billed 95991. They adivsed to use 62370. So i wanted to know what is reprogramming actually is? Help?
 
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