Code 62368 Components

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Hi All,

Code 62368 states "Electronic analysis or programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming. My question is...do all components in the parenthetical note have to be included (evaluation of reservoir status, alarm status, AND drug prescription status) since there is no and/or statement. Any help would be very much appreciated. Thank you! - Andre
 

dwaldman

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62368
Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming17

AMA CPT Changes 2012
The pump is then reprogrammed to adjust the rate of infusion and control the increased level of pain. The pump alarm settings and reservoir levels are programmed as well as any changes made to the drug infusion concentration or mixture. Refill date estimates are also made.

AMA CPT Assistant 2006

Clinical Scenario 3

A patient with a history of osteoporosis and multiple compression fractures presents to the clinic for a refill of her implanted spinal opioid delivery system. She meets with the physician, complains of slight worsening of pain since her last visit, and requests that the dosage be increased. The physician performs the refill and reprograms the pump with a 10% increase in daily dosage. The physician does not prescribe any medication and does not manage any other medical issues.

CPT code 95991 is reported for the pump refill provided by the physician. Code 62368 is reported for the reprogramming. No E/M code is reported for this scenario.

I think the above describes programming as it is typically documented. You usually see the increase or decrease of infusion rate, Estimated refill documented, but I think if the alarm status is not documented for example that does not prevent you from billing CPT 62368. This is just my personal opionion.

Additional information below:


17. Code 62367 is assigned for pump interrogation only (eg, determining the current programming, assessing the device’s functions such as battery voltage and settings, and retrieving or downloading stored data for review). Code 62368 is assigned when the pump is both interrogated and reprogrammed.


AMA CPT Assistant July 2012

Code 62368 is reported when electronic analysis is performed to determine reservoir status, alarm status, and the drug prescription status and reprogramming of the device occurs. The electronic analysis of the pump function verifies the infusion rate for which the pump is then reprogrammed (eg, to increase the rate of infusion and control the increased level of pain)


AMA CPT Changes 2012

Description of Procedure (62370) Electronic analysis is performed to determine reservoir status, alarm status, drug prescription status. The subcutaneous pump is palpated and identified. The entire area over the pump is prepped and draped. Throughout all this procedure, sterile technique is meticulous to prevent infection. A pump refill kit is then opened and extra required supplies added to the kit. The solution’s container is checked to be sure that the drug, the drug volume, and the drug’s concentration are all correct according to what was ordered. Using sterile technique, the drug to be injected into the pump is then drawn from its transport vial into a sterile syringe using a filter needle. The syringe is then connected to a Huber needle with an extension tube in the kit. The needle is advanced and probed to find the actual center of the pump reservoir and advanced through the injection septum of the pump into the reservoir to the proper depth. The residual volume of the solution is aspirated from the pump/reservoir and is measured and checked against the medical records and/or pump status printout to make sure the entire volume of the pump/reservoir has been removed. The syringe containing the new solution attached to the tubing and then very slowly injected into the pump/reservoir. The patient is examined and pump/reservoir are then checked for any possible error in administration. The pump is then reprogrammed to adjust the rate of infusion and control the increased level of pain. The pump alarm settings and reservoir levels are programmed as well as any changes made to the drug infusion concentration or mixture. Refill date estimates are also made.
 
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